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OR

c. Refer to MA-2300 Application and MA-2360, Medicaid Deductible when the applicant meets eligibility requirements for Medically Needy (MN).

C. Applications and Ongoing Cases – PACE Enrollment Complete

1. When an application is approved, or an ongoing change is processed on or before the second to the last workday of the month:

a. Authorization for PACE is the first day of the month following the month of PACE enrollment.

EXAMPLE:

Joe Jones is married and living with his spouse, Mary Jones. Mr. Jones applied for Medicaid and requested PACE services on June 27th. Mrs. Jones did not apply for Medicaid.

Mr. Jones also applies for enrollment with the PACE organization on June 27th.

Mr. Jones completes his enrollment with the PACE organization on July 7th. The PACE organization sends a referral to the local agency on July 8th verifying Mr. Jones’ PACE enrollment date as July 7th.

Joe’s caseworker establishes Medicaid eligibility and enters PACE evidence in NC FAST on July 20th. Medicaid PACE authorization is effective August 1st.

b. For applications, evaluate retroactive months for all Medicaid programs. See MA-2300, Application and MA-2260, Financial Eligibility Regulations-PLA

EXAMPLE:

Using the scenario in the above example, the caseworker should evaluate Mr. Jones for retroactive Medicaid for the months of March, April, and May. See MA-2300, Application

c. Evaluate ongoing months for all Medicaid programs. See section V.C, above for budgeting. Beginning with the month the PACE enrollment agreement is signed, budget the a/b as one.

EXAMPLE:

The caseworker will also evaluate Mr. Jones for the ongoing months of June and July for PLA Medicaid. See MA-2300, Application and MA- 2260, Financial Eligibility Regulations-PLA.