Page 7

7

a. Conduct all electronic matches, including OVS b. Check other available records c. Contact beneficiary only if continuing eligibility cannot be determined by available information

d. Issue a DMA-5097, Request for Information, allowing the beneficiary 12 calendar days to return the information.

B. Cost of living Allowance (COLA) 1. Always use the December Social Security benefit to determine eligibility under MQB-E. The RSDI COLA is excluded from countable income for January, February, and March of each year.

2. When the COLA increase is greater than the Federal Poverty Level, some Medicaid beneficiaries may lose eligibility or move to deductible status. In this situation, the most recent COLA must be disregarded in determining continued eligibility. If the beneficiary remains eligible when the SSA COLA is disregarded, the disregard continues until the beneficiary loses Medicaid eligibility or becomes eligible without the disregard.

C. MQB-E certification period is January through December of the next calendar year.

D. Information Not Received If the information needed is not retuned, send a timely notice to terminate the case. E. If the information necessary to determine eligibility is received after the case has been terminated, process an application.

1. Do not require the beneficiary to complete and sign a new application. 2. Enter a reapplication in NC FAST. Application processing standards apply. 3. The date of application is the date the necessary information was received.

loading…

Page 7

Official source

7

a. Conduct all electronic matches, including OVS b. Check other available records c. Contact beneficiary only if continuing eligibility cannot be determined by available information

d. Issue a DMA-5097, Request for Information, allowing the beneficiary 12 calendar days to return the information.

B. Cost of living Allowance (COLA) 1. Always use the December Social Security benefit to determine eligibility under MQB-E. The RSDI COLA is excluded from countable income for January, February, and March of each year.

2. When the COLA increase is greater than the Federal Poverty Level, some Medicaid beneficiaries may lose eligibility or move to deductible status. In this situation, the most recent COLA must be disregarded in determining continued eligibility. If the beneficiary remains eligible when the SSA COLA is disregarded, the disregard continues until the beneficiary loses Medicaid eligibility or becomes eligible without the disregard.

C. MQB-E certification period is January through December of the next calendar year.

D. Information Not Received If the information needed is not retuned, send a timely notice to terminate the case. E. If the information necessary to determine eligibility is received after the case has been terminated, process an application.

1. Do not require the beneficiary to complete and sign a new application. 2. Enter a reapplication in NC FAST. Application processing standards apply. 3. The date of application is the date the necessary information was received.