Adult Medicaid Manual MA-2320 REDETERMINATION OF ELIGIBILITY

REISSUED 07/01/10 – CHANGE NO. 10-10

I. POLICY RULES

A complete redetermination of all eligibility factors subject to change is required as follows:

A. Categorically Needy - No Money Payment

Once every 12 months for M-AABD coverage groups with stable income evaluated under CNNMP regulations in MA-2100, Categorically Needy-No Money Payment.

Having no income or a pending application for benefits is not stable income. Such persons would have a redetermination once every 6 months.

B. Medically Needy

Once every 6 months for M-AABD coverage groups evaluated under MN regulations in MA-2120, Medically Needy Regulations.

1. Re-enroll in deductible status:

a. All Medically Needy cases for a consecutive 6 month certification period if all eligibility requirements continue to be met, and

b. The deductible

(1) Was met in the previous certification period, or

(2) Is expected to be met in the next certification period. A reenrollment must be conducted to determine if the deductible is expected to be met in the next certification period.

If a case is authorized for meeting the deductible in the previous certification and the case has a deductible in the new certification period, send the recipient a timely notice for the new deductible.

2. Propose termination using timely notice:

a. If the case is ineligible in any other aid program category, and

b. If the previous deductible was not met and there is no indication that the deductible can be met in the next certification period.

REVISED 07/01/10 – CHANGE NO. 10-10

(I.B.2.b)

(1) If the recipient provides evidence within 10 workdays that the deductible was met or will be met within the certification period, do a complete re-enrollment of eligibility for the next certification period.

(2) If the recipient provides evidence after 10 workdays that the deductible was met, but before the 10th day of the following month, refer to reopen policy in MA-2304, Processing the Application.

3. Prior to termination, evaluate each individual in the case in other aid program/categories for ongoing benefits.

C. Medicare Coverage Groups

Once every 12 months for MQB-Q, MQB-B, and MWD groups evaluated under regulations in MA-2130, Qualified Medicare Beneficiaries - Q and MA-2140, Qualified Medicare Beneficiaries – B, and MA-2150, Medicaid – Working Disabled.