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• Reside in a county with an unemployment rate greater than the lesser of 8% or 1.5 times the national unemployment rate. o Subject to Federal approval

Program Participation Individuals eligible for expansion adult Medicaid coverage will be required to meet community engagement requirements, have a short-term exception, or qualify for an exclusion. For applications, the lookback period is (1) month prior to application. For redetermination, the lookback period is (3) months since the last redetermination. Community engagement requirements, exceptions, and exclusions must be verified. If the state verifies with data matching sources, no further verification is required of the member. If the state is unable to verify, the member is required to verify that they have met the requirements or verify the exclusion.

ACA Medicaid Expansion members/clients have multiple ways to self-report compliance with community engagement requirements, exception, or qualify for an exclusion, including online at apply.mt.gov, through the Public Assistance Helpline, by mail, Fax, and in person. There are multiple ways to verify an participation in community engagement, such as a statement from a physician or facility, written statements, enrollment in qualified programs, court documents. Etc. Ongoing exceptions or exclusions may need to be reverified with additional verification at redetermination. Penalties for non-compliance Individuals who have not met the community engagement requirements or qualify for an exemption or exclusion at their redetermination, or when changes are reported, will be notified they have 30 days demonstrate compliance with community engagement. Failure to verify community engagement during the 30-day period will result in denial or closure of Medicaid coverage. Once the individual is closed, they will need to reapply and demonstrate they are in compliance with community engagement requirements, have an exception, or qualify for an exclusion. Family Caregiver: An individual may be a caregiver of a dependent child or a disabled individual if they are an adult family member or other individual with a significant relationship. The community engagement exclusion may apply to individuals who provide care and: 1. They are a relative and provide primary care and may or may not live with the dependent child or disabled individual, 2. They are a parent, guardian, caretaker relative residing with the dependent child or disabled individual, or