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Where electronic data is not returned, the system will evaluate how recently any eligibility factors subject to change have been verified. If the individual has verified the required factors in the last six months (whether for a Medicaid benefit for someone in their household, or as a result of a SNAP application/recertification/interim report for their household), they qualify for an ex-parte renewal.
Individuals renewed on an ex-parte basis will be sent an approval notice which is prepopulated with the information (such as income, resources, and household members) which was used to make the determination. The notice will include instructions to notify DFR if any of the information is not correct. Changes reported after an ex-parte renewal has been completed are processed as changes in circumstances.
Individuals who do not qualify for ex-parte renewal will be sent a redetermination mailer as explained in 2205.15.00.
2205.05.00 ESTABLISHING THE REDETERMINATION (ANNUAL RENEWAL) MONTH
The redetermination month is the month during which eligibility is reevaluated for a new 12- month period. Federal regulations define the maximum time frames for completion of redeterminations for each program. Redeterminations (renewals) will be conducted for both MAGI and non-MAGI individuals once a year. If an individual is not determined to be eligible, their coverage will end on the last day of the redetermination month.
If there are multiple assistance groups in the case, the redetermination month for each individual may be different. The redetermination/renewal month is established based on the following requirements:
• Individuals under MAGI-based income must be redetermined once every 12 months, and no more frequently than once every 12 months1 • For Non-MAGI Medicaid, a redetermination must be completed at least once every 12 months2 • In some cases where all information needed to redetermine eligibility is reconfirmed for the AG, an ex parte redetermination can be done to start a new 12-month eligibility period if additional members are not required to take any action and eligibility is passing.