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2205.15.05 CHIP (MA 10) Renewals

CHIP members may qualify for ex-parte renewal if they meet the requirements, except for those who have overdue premium payments.

CHIP members who do not qualify for ex-parte renewal due to outdated information in the case or due to overdue premium payments will receive a must return mailer. When redetermining eligibility for this new 12-month period, CE protection is lifted, and normal eligibility rules apply. If a member fails to return mailer, documentation, and/or fails to pay outstanding premiums by the last day of the renewal month, benefits will be terminated. If outstanding payments are not received by the last day of the renewal month, members must reapply.

CHIP members discontinued at point of redetermination for failing to verify required information are entitled to 90-day reconsideration period (refer to 2238.25.00). If members come into compliance by submitting all required renewal documentation within this period, their case should be reviewed for a possible rescind. These individuals are not required to submit a new application.

• Individuals who come into compliance before the last day of the renewal month and continue to form CHIP (MA 10) should be restored to a fully open status • Individuals who come into compliance after the last day of the renewal month, but in the 90-day reconsideration period, and continue to form CHIP (MA 10) should restart in a conditional status There may sometimes be a delay in receiving a premium payment, and the record will come in after the case is set for closure. Based on the payment date, individuals who paid their outstanding payment(s) before the last day of the renewal month and meet all other eligibility requirements must be reviewed as a potential rescind and, if eligible, should be restored to a fully open status.

CHIP members closed at renewal for being over the income limit or for non-payment of premiums are not entitled to 90-day recission period and a new application is required. Normal processing guidelines apply for any applications received on or after the effective date of closure. Children who meet all eligibility requirements for CHIP except for payment of the first premium(s) will start out in a “conditional” status until the first premium is received.

2215.00.00 CHANGES

The individual may report a change in circumstances or the DFR may learn of a change which could affect eligibility or the benefit amount. The worker is responsible for promptly evaluating the change and taking any indicated action to adjust the benefit. A person eligible under MASI