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BEM 136 2 of 3 PRESUMPTIVE ELIGIBILITY BPB 2016-001 1-1-2016

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

 Former Foster Care Children  Certain individuals needing treatment for breast and cervical cancer. Eligibility Period The presumptive eligibility period begins on the date the determination is made by the qualified entity. The end date of the presumptive period is the earlier of:  The date the eligibility determination for ongoing Medicaid is made, if an application for Medicaid is filed by the last day of the month following the month in which the determination of presumptive eligibility is made: or  The last day of the month following the month in which the determination of presumptive eligibility is made, if no application for Medicaid is filed by that date. The beneficiary must complete a health care coverage application and receive a determination to avoid losing coverage when the temporary eligibility period ends. This must be completed within 60 days of the date of the presumptive eligibility determination. Presumptive eligibility is limited to one period of eligibility during any consecutive 12 month period. Pregnant women are limited to one presumptive eligibility period per pregnancy. Covered Services Presumptive eligibility benefits for infants, children and adults are the same as those provided under the Medicaid category for which the individual is determined to be presumptively eligible. Coverage for a pregnant woman is limited to ambulatory prenatal care services only. Covered services include physician visits for prenatal care, prescription drugs related to pregnancy and prenatal laboratory tests.

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Official source

BEM 136 2 of 3 PRESUMPTIVE ELIGIBILITY BPB 2016-001 1-1-2016

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

 Former Foster Care Children  Certain individuals needing treatment for breast and cervical cancer. Eligibility Period The presumptive eligibility period begins on the date the determination is made by the qualified entity. The end date of the presumptive period is the earlier of:  The date the eligibility determination for ongoing Medicaid is made, if an application for Medicaid is filed by the last day of the month following the month in which the determination of presumptive eligibility is made: or  The last day of the month following the month in which the determination of presumptive eligibility is made, if no application for Medicaid is filed by that date. The beneficiary must complete a health care coverage application and receive a determination to avoid losing coverage when the temporary eligibility period ends. This must be completed within 60 days of the date of the presumptive eligibility determination. Presumptive eligibility is limited to one period of eligibility during any consecutive 12 month period. Pregnant women are limited to one presumptive eligibility period per pregnancy. Covered Services Presumptive eligibility benefits for infants, children and adults are the same as those provided under the Medicaid category for which the individual is determined to be presumptively eligible. Coverage for a pregnant woman is limited to ambulatory prenatal care services only. Covered services include physician visits for prenatal care, prescription drugs related to pregnancy and prenatal laboratory tests.