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COMAR 10.09.24.03

379 State of Maryland Medical Assistance Manual Revised July 2012 If the child‟s resources become over-scale for T02 but the income remains within standard for T03-T05 depending on the child‟s age, CARES will trickle the AU to appropriate T-track coverage group with respect to the child‟s age. If the trickling does not occur properly, the MA CM should Add-A-Program to determine eligibility in the most appropriate coverage group.

T03-T05 Who Become Income- Ineligible

If the resources become over-scale for T02 but the income remains within standard for T03-T05 (based on the child‟s age) but does not exceed the LRCF‟s cost-of-care, the case manager should Add-A-Program to determine the child‟s eligibility for T02.

Child who Age Out of Coverage Group or No Longer Qualifies Due to Marriage

For a child in T03-T05, the CM should set an alert to trigger an unscheduled redetermination at least 90 days before the child reaches the age limit for the coverage group. The T03 should be tested for T04, the T04 should be tested for T05, and the T05 should be tested for T02. If the child being tested for T04 or T05 has resources that are within the T02 standard and the income is over the standard for T04 or T05, and the T05 (based on the child‟s age) but does not exceed the LTCF‟s cost-of-care, the CM should Add-A-Program to determine the child‟s eligibility for T02. If the child who is aging out of T05 is married, the CM must redetermine eligibility under the ABD rules of L98. When a child in T02 becomes 20 years old, the CM should set an alert to trigger an unscheduled redetermination at least 90 days before the child reaches 21 years old. The recipient‟s LTC eligibility should redetermined under the ABD rules for L98. When a child in T02 gets married, the CM must redetermine eligibility under the ABD rules of L98.

Unscheduled Redetermination When Recipient is Discharged for LTCF

When a T-track recipient is discharged from a LTCF an unscheduled redetermination is required. MA eligibility may not be terminated until it is determined that the recipient is not eligible for community MA or MCHP. The redetermination procedures for a child discharged from a LTCF are similar to the specific procedures discussed in Chapter 10, Redeterminations Procedures for Children Under the Age of 21 Being Discharged from IMDs, RICAs, or RTCs. For Adults discharged to the community, the policies and procedures are addressed on pages 1000-55 and 1000-56 of the MA Eligibility Manual.