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MEDICAL SERVICES POLICY MANUAL,SECTION C C-100 Application Process

C 141 90 Day MAGI Application Process

4. If additional information is required to process the application due to reasonable compatibility issues or missing data, the system will send a notification to the individual requesting the needed information. 5. An interview with the applicant is not required. The applicant will be contactedonly if necessary to obtain necessary information. 6. When all requested information is supplied by the applicant, the caseworker will enter the information into the system which will then determine eligibility. 7. If the application is denied, the system will send a notification of denial and, if appropriate, provide the individual with referral information to the Health Insurance Marketplace to allow the individual to apply for services there.

C-141 90 Day MAGI Application Process MS Manual 10/08/15 A new application will not be required in those instances in which an application for families and individuals (MAGI) groups was denied due to the applicant’s failure to provide requested information within the 10 day notice period when the requested information is provided within 90 days of the application denial date. The original application will be reinstated and the information will be used to determine eligibility. A new application will be required if the requested information is returned after 90 days. This only applies to applications for the MAGI groups.  NOTE: When an applicant provides requested information after the application has been denied but within the 90 day window, the application will be considered as a reinstatement and will not be subject to the 45 day overdue guidelines. However, the reinstated application must be processed and eligibility determined within 10 days from the date the requested information was supplied.

Example: A verification request notice is sent to the individual on August 15 and it is due back in the office on or before August 25. The requested information is not returned and a system generated notice is sent informing the individual of the application denial. The application is denied on August 26. The individual provides the requested information by November 24th which is 90 days from August 26th. Therefore, the information will be used to process eligibility and if eligible, coverage will begin based on the original application date.