Obsolete 0125 827 Eligibility For Other Programs

Effective Date: November 1, 2023 - Decmeber 31, 2024

Previous Policy

 

All Medical Programs

Before closing a Medicaid program, review each  member for eligibility under other medical assistance programs.  This includes, but is not limited to: Foster Care related programs (354), Subsidized Adoption (355), Medicare Cost Sharing programs (320), Children’s Health Insurance program or UPP.  

 

1.    Do not require a new application. Application policy and time frames apply (703).

2.    Determine eligibility for other programs until the member: 

a.    no longer qualifies for any other medical program,

b.   states they no longer want medical coverage,

c.    has moved out of state,

d.    cannot be located, or

e.    is deceased.

3.   If possible, determine eligibility without contacting the member. If you need information or verification from the member, follow the verification policy found in 731.

4.    If the member is a minor while on Medicaid and ages off;

a.    Using the parent or guardian signature, open a new Medicaid program,

b.   Request a new signature page (731), and

c.    Narrate where the parent or guardian signature can be found.

5.   Close the program when the household no longer qualifies for any medical program or requests closure of their coverage. Follow advance notice requirements policy in 811.  

6.   Do not extend a time-limited program (721-4) past the month the time limit has ended. See 349 for Pregnant Woman policy.

7.   If an SSI recipient stops receiving SSI payments, see 329303-6 and 330.