Procedures

Follow the steps below to establish Medicaid eligibility for the AU under 4MEx.

Determine the amount of spousal support, the date of first receipt and the date reported by the AU. Refer to 2051 Verification .

Determine Parent/Caretaker with Child(ren) ineligibility because of spousal support income; or spousal support income in combination with other MAGI income; or other concurrent change, but not the other MAGI income or concurrent change alone.

Establish that the AU correctly received Parent/Caretaker with Child(ren) in three of the six months preceding the first month of ineligibility for Parent/Caretaker with Child(ren).

Terminate Parent/Caretaker with Child(ren) and approve 4MEx for the AU effective the month following the expiration of timely notice by entering the new or increased income in GA Gateway and allowing the case to cascade to Four Months Extended.

Notify the A/R of the change, specifying the four months of Medicaid eligibility under 4MEx and the individuals covered. GA Gateway will issue the notice.

At the end of the four month eligibility period, complete a Continued Medicaid Determination (CMD) and notify the AU. Refer to 2052 Continuing Medicaid Determination .

Use the following chart to determine the action to be taken because of changes in the AU during the Four Months Extended Medicaid time period.

CHART 2170.1, CHANGES IN AU DURING FOUR MONTHS EXTENDED MEDICAID IF THEN discontinue 4MEx for AND reinstate 4MEx effective the individual whose MAGI income qualified the AU for 4MEx leaves the home OR the only child in the AU leaves the home the entire AU and complete a CMD. Refer to 2052 Continuing Medicaid Determination . If the only child leaves the home, provide a copy of the Medicaid Certification to the adult with whom the child is now living while a CMD is being completed. Use the existing case number during this time. the month the individual returns, only if there are months remaining in the original 4MEx time period. any other AU member leaves the home the individual leaving the AU the month the individual returns to the AU, only if there are months remaining in the original 4MEx eligibility period. the entire AU leaves Georgia the entire AU the month the AU returns to the state, only if there are months remaining on the original 4MEx eligibility period. the only child in the AU reaches age 19 the entire AU and complete a CMD. Refer to 2052 Continuing Medicaid Determination . N/A