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DocuSign Envelope ID: 3289A281-EC13-40C5-A56D-BE1F23756321 North Carolina Department of Health and Human Services AGED, BLIND AND DISABLED MEDICAID MANUAL MA-1000 18

SSI MEDICAID – AUTOMATED PROCESS

REISSUED 11/01/11 – CHANGE NO. 17-11 (VII.G.) 3. If eligibility is established in any coverage group, the certification period begins with the current processing month in EIS.

Example: Review completed January 27. The current EIS processing month is March. The new certification period begins March 1.

4. If the recipient is eligible as MQB (Q, B or E) only, transfer the case to MQB.

5. Deductible Cases

a. If the recipient is eligible for Medicaid but must meet a deductible, contact the recipient regarding his predicted or outstanding medical expenses to determine if he can meet the deductible.

He can if:

(1) His deductible amount is $300 or less, or

(2) His predicted expenses or old bills are within $300 of meeting the deductible.

b. If it is determined that the recipient can meet his MAABD deductible:

(1) Certify and put the case in deductible status.

(2) Follow deductible policy in MA-2360, Medicaid Deductible, to apply medical expenses to the deductible.

(3) Indicate the deductible amount on the automated notice.

c. If it is determined that the recipient can meet an MAF deductible:

(1) Terminate the MAABD case.

(2) Enter an administrative DSS-8124 to open an MAF case.

(3) Pend the application to meet the deductible. (MAF cases cannot be approved in EIS in deductible status.)

d. If it is determined that the recipient's deductible is greater than $300 or the predicted medical expenses are not within $300 of meeting the deductible, send timely notice to propose termination.