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3 130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 259 Rev. 02/13/26

130 CMR 522.000: MASSHEALTH: OTHER DIVISION PROGRAMS

(5) During the first six months after disenrolling from MIC and enrolling in comprehensive MassHealth coverage, the member may request to go back to the MIC Program, be disenrolled from their comprehensive MassHealth coverage type, and be considered continuously enrolled in MIC under 130 CMR 522.001(B)(1). Such disenrollment from comprehensive MassHealth coverage shall be treated as a voluntary withdrawal from their MassHealth coverage. (6) An MIC member who disenrolls from MIC to enroll in comprehensive MassHealth coverage shall be given written notice of their rights under 130 CMR 522.001, including how MassHealth enrollment affects their future eligibility for MIC as described in 130 CMR 522.01.

(D) Verifications. Applicants must have submitted the following verifications to the MIC Program coordinator within 45 days of the receipt of the application by the MassHealth agency: (1) a written statement of a diagnosis of AIDS or HIV by the examining licensed physician; (2) documentation of receipt of Social Security disability benefits or Supplemental Security Income; and (3) documentation of gross annual income.

(E) Redetermination of Eligibility. The MassHealth agency completes a redetermination of eligibility for each program participant on an annual basis or as needed.

(F) Termination of Benefits (1) When a program participant no longer meets one or more of the conditions in 130 CMR 522.001(B), the MassHealth agency terminates premium payments for that program participant effective on the next premium payment due date. However, the following exceptions apply: (a) in the event of the death of a qualified individual who has coverage under a family plan, payment for the continuation of the existing plan will not exceed a period of three months following their death; and (b) if a qualified individual relocates to another state, they will be afforded one additional premium payment after relocation to cover the transition period. (2) The MassHealth agency sends written notice to program participants of the termination of premium payments, the reason for the termination, and the individual's right to appeal such termination in accordance with the provisions of 130 CMR 610.000: MassHealth: Fair Hearing Rules.

522.002: Refugee Resettlement Program

(A) Regulatory Authority. The Refugee Resettlement Program (RRP) is regulated pursuant to Chapter 2 of Title IV of the Immigration and Nationality Act (INA), 8 U.S.C. 1521 and Refugee Medical Assistance (RMA) is provided in accordance with 45 CFR 400 Subpart G.