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MEDICAL SERVICES POLICY MANUAL,SECTION I I-600 Changes I 610 Loss of Eligibility

I-610 Loss of Eligibility MS Manual 07/01/20

Loss of eligibility occurs when the eligible individual: • Moves from Arkansas • Requests closure • Dies • Is found to be over the income limit • Is found to be over the resource limit if applicable • Reaches the age limit for the eligibility • Leaves the nursing facility • No longer meets medical necessity • Has three (3) months of non-compliance with the Adult Expansion Group work requirement within a calendar year Depending upon the change, the individual may be eligible in another eligibility group. For example, if a child ages out of ARKids, he/she may be eligible in an adult group such as the Adult Expansion Group. When possible, eligibility in another group should be determined at the time ineligibility for the current group is established. EXCEPTION: Once eligibility is established for a pregnant woman (PW) in any Medicaid category, there will be “No Look Back” at later income increases throughout the pregnancy and the postpartum period. The PW will remain Medicaid eligible through the end of the postpartum period regardless of increases in income. Refer to MS C-205 and MS I-690. I-620 Alternative Change/Closure Processes MS Manual 07/01/20

Some eligibility groups have specific processes thatmust be followed when a change or closure occurs. These groups include: • ARChoices in Homecare Waiver • Assisted Living Facility (Living Choices) Waiver • Division of Devlopmental Disability Services Waiver