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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 | 65 Effective Month: September 2023 101.10.06 RETROACTIVE MEDICAID FOR SSI ELIGIBLES AND FILLING IN GAPS Persons eligible for SSI may be eligible for additional months of eligibility beyond the SSI retroactive period. This period of coverage includes the month of application for SSI and any other missing months of eligibility that exist until the month the SSI payment begins. The SSI eligible person must apply for and be determined eligible for ABD coverage for the interim period of missing SSI eligibility.
An application for the interim period of missing SSI eligibility can be filed at any time and may or may not be filed in conjunction with an application for SSI retroactive Medicaid. However, if an application for retroactive Medicaid was filed and either approved or denied within 90-days of a request to fill in missing month(s) of SSI eligibility, reinstate the prior application using current verification needed to determine eligibility for any missing month(s). The reinstatement is only for the purpose of using the previous application. Eligibility is approved only for the missing month(s) provided the SSI individual is eligible in the missing month(s). 101.11 NOTIFICATION The recipient and, when applicable, the medical facility must be notified in writing or electronically of the action taken on an application or an active case when eligibility or benefit level is affected by a change either at the time of a full review or as a result of a reported change prompting a special review. Notices are generated by the system based on the type of contact and the results of the eligibility determination. NOTE: It is the specialist’s responsibility to review and, if needed, correct notices in the system before they are mailed to the recipient. If a manual notice is required for the recipient, refer to instructions for the DOM-305, Notice of Action, or DOM-306, Notice of Adverse Action. When a manual notice must be issued to a facility, DOM-317, Exchange of Information Between Long Term Care Facility and Medicaid Regional Office, is used.