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CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

103 c. To qualify for limited family planning presumptive eligibility, an applicant must have declared household income greater than 133% but not exceeding 260% of the federal poverty level. The applicant cannot be eligible for a Medicaid eligibility category that provides full coverage. The applicant must declare they are a United States citizen or a lawfully residing immigrant. An applicant applying for limited family planning presumptive eligibility will be counted individually as a household member of two. 3. Presumptive eligibility sites shall be certified by the Department to make presumptive eligibility determinations. Sites shall be re-certified by the Department every year to remain approved presumptive eligibility sites. 4. The presumptive eligibility site shall forward the medical assistance application to the County Department of Human Services within five business days. 5. The presumptive eligibility period begins on the date the applicant(s) is determined eligible and ends with the day an eligibility determination for Medical Assistance is made for the applicant(s) 6. A presumptively eligible member may not appeal the end of a presumptive eligibility period. 7. Medical Assistance applicants may appeal if a County Department of Human Services is unable to act within 45 days or 90 days (if a disability determination is required) of the medical assistance application date or the denial of a medical assistance application. Appeal procedures are outlined in the State Hearings section of this volume. 8. Applicants cannot receive presumptive eligibility if they are already in receipt of another medical assistance program. 9. An applicant may only receive presumptive eligibility once every 12 months with the exception of pregnant women who may receive presumptive eligibility once every pregnancy. 8.100.4.G. MAGI Covered Groups