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MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD Prior Medicaid coverage may be provided even if the: • Household is not currently eligible for Medicaid; or • Person who received the medical care or services is deceased. Individuals determined eligible for a month of prior medical coverage are eligible from the first (1st) day of month, regardless of when the eligibility requirements were met. D-365.3 Prior Medical Income Computation Use actual income and expenses when determining eligibility for prior medical coverage. Determine the assistance unit’s countable income. Compare the countable income to the income limit for each month that eligibility is being determined. D-370 REINSTATEMENTS Reinstatements are allowed for the following reasons: • The household provided verification within 10 days from date of denial. • The household provides verifications prior to the termination action being taken. • The customer provides RD form and all verifications within 90 days from termination of RD. (see Mam D-400 Redeterminations) Reinstatements for other reasons are made at the discretion of the Social Services Manager (SSM) or supervisor. D-375 “PRUDENT PERSON" PRINCIPLE The policies included in the manual are rules for determining eligibility. It is impossible to foresee and give examples for all situations; therefore, staff are encouraged to use reason and apply good judgment in making eligibility decisions when rare and unusual situations are encountered. Reasonable decisions made by staff based on the best information available using good judgment, program knowledge, experience, and expertise in a particular situation is referred to as the prudent person principle. Document the rationale used to make a decision and any applicable manual references and policy interpretations. Follow local office procedures for obtaining an interpretation from Eligibility and Payments (E&P) Program Specialists requesting clarification or directives, when it is impossible or inadvisable to follow the prudent person principle because of a lack of information or program knowledge. Note: Suspicious circumstances should be referred to Investigations and Recovery (I&R) using the appropriate I&R referral process. D-380 KATIE BECKETT Applications must first be evaluated for all other Modified Adjusted Gross Income (MAGI) coverage groups. If determined ineligible for any MAGI programs, follow the process below for evaluation of the Katie Beckett program. D-365.2 MAABD APPLICATION PROCESSING Eligibility for Prior Coverage Division of Social Services Medical Assistance Manual 14 Aug 25 MTL 11/25