Additional Six-Month Extension

Follow the steps below to continue eligibility for the additional six-month extension of TMA.

Step 1 Mail Form 328 - Quarterly Report Form (QRF) by the 15 th day of the sixth month of TMA if the recipient complied with fourth month reporting and received all six months of TMA during the initial extension. Request MAGI income for the fourth, fifth and sixth months of TMA. All MAGI income reported on the QRF must be verified. Refer to Section 2051 - Verification . The QRF is due by the 5 th day of the seventh month. If the QRF is not received by the 5th day, a Discontinuance Due to No QRF notice will be sent as a reminder the QRF is due by the 21st. Step 2 Complete TMA budgeting procedures in the seventh month after the QRF is returned by the AU. Refer to Section 2667 - Transitional Medical Assistance Budgeting and Chart 2166-2, TMA QRF Processing Procedures for the Seventh and Tenth Months . If the AU remains eligible based on the TMA budget, continue TMA. If the AU is TMA ineligible because of MAGI income reported on the QRF, or if ineligible for any other reason, complete a Continuing Medicaid Determination (CMD) prior to termination of TMA and notify the AU. Refer to Section 2052 - Continuing Medicaid Determination . Step 3 Mail Form 328 - Quarterly Report Form (QRF) by the 15 th day of the ninth month of TMA if the recipient complied with the seventh month QRF. Request MAGI income for the seventh, eighth and ninth months of TMA. Refer to Section 2051 - Verification . All MAGI income reported on the QRF must be verified. Refer to Section 2051 - Verification . The QRF is due by the 5 th day of the tenth month. If the QRF is not received by the 5th day, a Discontinuance Due to No QRF notice will be sent as a reminder the QRF is due by the 21st. Step 4 Complete a TMA budget in the tenth month after the QRF is returned by the AU. Refer to Section 2667 - Transitional Medical Assistance Budgeting and Chart 2166.2 - TMA QRF Processing for the Seventh and Tenth Months . If the AU remains eligible based on the TMA budget, continue TMA. If the AU is TMA ineligible because of MAGI income reported on the QRF, or if ineligible for any other reason, complete a CMD prior to termination of TMA and notify the AU. Refer to Section 2052 - Continuing Medicaid Determination . Step 5 Complete a CMD during the 12th (final) month of TMA eligibility and notify the AU prior to termination of TMA. Refer to Section 2052 - Continuing Medicaid Determination .