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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 | 74 Effective Month: September 2023 101.14.03 ADULTS Adults generally have no protected period of eligibility. Changes in income and other circumstances can impact an adult’s eligibility as such changes occur. However, women eligible solely due to pregnancy in any COE program are provided coverage from their first eligible month through the post-partum months regardless of any subsequent changes in income, household composition, etc. This includes women whose eligibility originated in a non- pregnancy related coverage group, such as QMB or Family Planning, who are determined eligible for any COE and transition to any COE for coverage of pregnancy related services for the duration of her pregnancy and post-partum months. In such instances, eligibility must be reviewed for the impact of any changes in circumstances after transitioning back to her original coverage group. 101.15 THE REDETERMINATION OR RENEWAL PROCESS Redetermination is the process of verifying whether a recipient continues to meet the eligibility requirements of a particular program. Redeterminations are classified as either regular or special reviews. A regular review is an annual review of all eligibility factors that are subject to change. A special review is completed when a portion of the case must be re- worked, or case information must be updated because of a change. This chapter addresses the redetermination process. 101.15.01 REGULAR REDETERMINATIONS OR RENEWALS – MAGI & ABD Federal regulations require that the eligibility of every Medicaid and CHIP recipient be reviewed at least every 12 months. Mississippi state law also requires annual reviews. During the regular redetermination process, the recipient’s circumstances are reviewed and each eligibility factor that is subject to change, such as income and/or resources, is re-evaluated. Recipients are not asked to provide information that is not relevant to ongoing eligibility or that already been provided and is not subject to change.