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COMAR 10.09.24.04

324 State of Maryland Medical Assistance Manual Revised July 2012

Income information from a former employer

As documentation of efforts to obtain the required information, the applicant is expected to request a written, signed, and dated statement from the source of the requested information on letterhead stationary when the request for the information is made. Local departments may need to use some other type of evidence satisfactorily documents that the delay is not the fault of the applicants.

In the case of information needed on life insurance, the applicant should request assistance from the insurance agent who can likely obtain the information quicker through computer printout or other automated files.

If the time frame associated with the extension is not met, another extension may be granted if the applicant presents updated written proof that he/she has made follow-up requests for the information. The process may continue so long as the applicant presents current proof of his/her efforts to obtain the required information. Although the primary responsibility for providing information rests with the applicant, assistance by a local department is not precluded. If, however, a local department assumes full responsibility for obtaining the required information, the local department is obligated to retain that application in pending status. An applicant can only be held accountable for those activities that have been assigned to him/her.

(h)Retroactive Eligibility

Retroactive eligibility may be considered for those months in the retroactive period in which the person has incurred medical expenses. The period under consideration is 1, 2 or 3 months immediately preceding the month of application Review each retro month separately Example: Application date Jan 1, 2012 Retro months= October 2011, November 2011, December 2011 Retro can be considered for all three months or just one or two months All technical and financial factors must be assessed for the months in which there are incurred medical bills for which the person is applying for assistance If the applicant requests MA for the retro and the current, separate eligibility determinations are required. The information may be collected on the same application NOTE: An applicant can be found ineligible for one period and not the other, eligible for both or ineligible for both.

(i) Retroactive and Current Periods

If the applicant request MA for the retroactive as well as the current period, separate eligibility determinations are required, though the information may be collected on single application form. An applicant may be found ineligible for one period and not for the other, eligible for both, or ineligible for both.

Examples: