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MEDWorks, each spouse will be designated as his or her own premium payer. However, the premium will be a ‘couple premium’, meaning one premium is assigned to both spouses. Both will be enrolled when the one premium is paid, and both will be denied if the premium is not paid. One billing statement will be sent to the couple. Applicants who pass all eligibility requirements and based on income are required to pay a premium to be enrolled will be conditionally approved until the premium is paid. The first premium month is the month following the month of authorization. All prior months in which the individual is eligible are premium-free.

2035.35.00 DETERMINATION OF INELIGIBILITY

An AG is to be denied if just one eligibility requirement fails to be met causing the AG to be ineligible. However, if, during the eligibility study the worker verifies that other requirements are not met; all reasons for denial must be entered on the Eligibility Determination Results page 2035.40.00 AUTHORIZATION An AG must be authorized when all required eligibility information is documented, and the determination of eligibility is complete. Please note the exception in section 2035.40.05. In all other instances, AGs are to be authorized whenever the eligibility determination is complete. Authorization of an AG is not to be delayed while awaiting completion of the eligibility determination for other AGs in the case.

Before authorizing an AG, the worker should carefully review all data and the case eligibility results for accuracy. This involves reviewing every retroactive month as well as the recurring month. 2035.40.05 AUTHORIZING WHEN CITIZENSHIP OR IMMIGRATION STATUS IS NOT VERIFIED If a person would be determined otherwise eligible for Medicaid under any category due to meeting all verification requirements of Medicaid, except for the verification of either citizenship or qualified immigration status, then the person must be determined eligible for Medicaid. Please refer to IHCPPM 2402.20.00 for individuals declaring to be immigrants.

Persons who do not have citizenship or qualified immigration status verified promptly by the DFR through an electronic match or by other means but can otherwise be determined eligible are given 95 days from intake date to provide proof of citizenship or qualified immigration status. The system will automatically generate a notice of Reasonable Opportunity if electronic interface verification for citizenship fails. Additionally, the Notification of Requirement to Provide