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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 64 Effective Month: September 2023 eligibility granted under PEP begin date rules will be changed to full month eligibility.

101.10.04A RETROACTIVE MEDICAID FOR ABD APPLICATIONS Eligibility in a retroactive month cannot be assumed based on current month eligibility. Determine eligibility for each month separately using the eligibility rules in effect for that month, actual income received in each month and actual resources available in each month. NOTE: Annual Cost-of-Living Adjustment (COLA) increases in Federal benefits cannot be used to determine ABD eligibility in any given year until the Federal Poverty Level (FPL) limits have been implemented for that year. Therefore, when determining retroactive or ongoing eligibility for the months of January, February and possibly March, the prior benefit amount must be budgeted, rather than the actual amount. 101.10.04B RETROACTIVE MEDICAID FOR MAGI-RELATED APPLICATIONS Income determined for current eligibility is used for the retroactive period for MAGI-related cases unless there was a change that must be considered for eligibility in the retroactive period. Accept the applicant’s statement regarding income sources and amounts in the retroactive period unless there is some reason to question the accuracy of the statement, such as electronic data source verification is inconsistent with the applicant’s statements or declared information. For purposes of determining Extended Medicaid eligibility, retroactive Medicaid can be used to determine whether an applicant would have been eligible for Medical Assistance (in three of the last six months. 101.10.05 RETROACTIVE MEDICAID FOR DECEASED APPLICANTS An application for retroactive Medicaid coverage may be made on behalf of a deceased person. Retroactive eligibility can cover all 3 months prior to the month of application or any month(s) in the 3-month period if the deceased person is found to be eligible.