Page 29

28

If a MEDWorks recipient loses employment involuntarily due to being fired, laid off, or the employer closed the business, continuation of coverage is possible under the circumstance explained in this section.

A person who quits a job or closes his own business is not entitled to MEDWorks coverage continuation. MEDWorks can continue if the recipient goes on temporary medical leave, and his job is being held open by his employer. If a person goes on indefinite or long-term disability status, he is not entitled to coverage continuation under this provision. When employment is lost involuntarily, coverage continuation is possible if the recipient maintains an attachment to the workforce under one of the following circumstances: • Enrollment in a Vocational Rehabilitation program • Enrollment or registration with the Department of Workforce Development • Participation in a transition from school to work program • Participation with an approved provider of employment services. When the recipient reports that they are no longer working, the worker must ask him if them if they will remain attached to the workforce under one of the above circumstances. If the recipient is otherwise eligible, and states that they will participate in one of the workforce attachment activities, the worker is to enter the activity in IEDSS (Indiana Eligibility Determination Services System) and give the recipient Form 2032, Pending Verifications stating that documentation of the workforce attachment must be submitted within 60 days of the date that person stopped working. The documentation must be from the agency or service provider with whom the recipient is registered/enrolled. In the situation of medical leave, the recipient must provide a statement from the employer that the medical leave is temporary, and the job is being held open for the recipient. If the recipient does not provide this documentation within 60 days after the employment ended, they are no longer entitled to MEDWorks. Eligibility must be explored for the other Medicaid categories. If the recipient provides the initial documentation of workforce attachment, continued verification is required quarterly. The recipient is entitled to 12 months of coverage continuation. If, after 12 months, they are not working, they are no longer eligible for MEDWorks. Eligibility under the other Medicaid categories must be considered. 3455.10.00 ELIGIBILITY UNDER THE SPEND-DOWN PROVISION (MED 1) As of June 1, 2014, this section no longer applies.