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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |352 Effective Month: December 2016 COMBINATION MAGI AND ABD APPLICATIONS (Continued)

MAGI Application Filed with the FFM Indicates Possible ABD Eligibility

For MAGI applications filed with the FFM and referred to DOM as an Account Transfer, the system recognizes any affirmative responses to the questions that indicate a request to apply for ABD Medicaid and issues DOM-304, Non-MAGI Application Letter (located in the Appendix page by the same name). This letter informs the applying household member that additional information will be needed if the applying household member wants to pursue applying for Medicaid on the basis of disability, i.e., resource information and disability information unless the individual has already been determined disabled by SSA. The letter instructs the individual to sign, date and return the letter to DOM by mail, in person, by fax or email if he/she wants to continue with an application for ABD Medicaid or, if needed, the individual can contact the agency by phone to continue the process.

If an individual signs and returns the “Non-MAGI letter” to the agency via any means acceptable for filing an application, an ABD application must be issued to the individual and the steps described above in “MAGI Application Filed with DOM Indicates Possible ABD Eligibility” must be followed for processing the ABD application.

If a signed non-MAGI letter is not returned to the agency, no further action is required.