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 For persons who are hospitalized, written documentation from a hospital or other medical professionals on the hospital or provider letterhead, attesting that the applicant is not available for an interview due to disability or illness, including a diagnosis and prognosis, and that the applicant will not be available for the 45-day period beginning with the date of application. These waiver requests will be reviewed by the Medical Review Team.  For persons who are age 65 or older, a written statement from the applicant explaining why they cannot participate in the face-to-face interview during the 45-day period beginning with the date of application. Waiver requests from persons who are elderly will be reviewed by the Agency on a case-by-case basis.

Application Timeframes 4.5.3

Applications for the Alliance program must be processed within 45 days, counting from the day after the application was filed. A verification checklist, listing all information or actions still needed to determine eligibility must be issued through ACEDS and given to the applicant at the time the application is filed. The checklist and the date the application was filed are essential for the timely issuance of all application notices and timely disposition of the application.

If an applicant fails to provide all necessary verification by the tenth day following the application date, ACEDS will issue a Ten-Day Notice that lists the information or actions needed to complete the eligibility determination. If the applicant still has not provided all necessary verifications by the 30th day following the application date, ACEDS will issue a 30-Day notice that also reports what is needed to complete the eligibility determination.

If by the 15th day following the 30-day notice (or the next available workday), the applicant has not provided all verifications, ACEDS will issue a denial notice and deny the application.

It is ESA’s goal to complete the eligibility determination within 10 days from the date that all information necessary to determine eligibility has been submitted.

Expedited Determinations 4.5.4

ESA shall conduct expedited determinations (on the same or next business day) for any applicant who has an urgent medical need that is certified by a clinician. Applicants may request an expedited determination from the IMA Office of the Administrator by telephone, fax, or in person. A need for an expedited determination does not relieve an applicant from the requirement to participate in a face-to-face interview, unless waived (see Section 4.5.2a: Request for Waiver of Face-to-Face Interview in this Part.)

Application Approvals 4.5.5

If all financial and nonfinancial conditions of eligibility are met, the SSR will approve benefits.

Period of Eligibility 4.5.6

Eligibility shall begin on the first day of the month of application. Effective September 27, 2011, applicants shall be certified for six (6) months.

Applicants are not eligible for coverage for any month prior to the month of application.