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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL D-540 Division of Welfare and Supportive Services CHANGES Medical Assistance Manual CONVERSIONS 24 Jan 25 MTL 02/24 c. cut-off, allow the change in eligibility to take effect in the next administrative month. (Example 1) REHA 05/15/2015, change effective 6/01/2015. (Example 2) REHA 05/29/2015, change effective 7/01/2015. 2- Nevada Check-up to SSI Case

a. Verify SSI eligibility. Create a sub-case if SSI recipient is not head of household, or if others in household have Medicaid.

b. Terminate eligibility under current category prior to cut-off and approve SSI eligibility for the following month. View and post a corrected version to update the aid code and eligibility code and then notify the customer of the change in benefits. Evaluate for parental financial obligation for children under 18 if there is no deeming of parental income/resources in determining eligibility.

3- Requesting a Refund of Premiums

a. If after case processing the household is determined eligible for a new family medical aid code or a new MAABD subcase has been created, a refund may be requested from DHCFP for any future months in which NCU premiums have already been paid by the household. Only months that were converted from NCU to another aid code/program can be included in this request.

Note: Retro refund requests will be evaluated on a case-by-case basis and

authorized only if deemed appropriate.

b. DWSS staff should email the NCU Specialist with case information regarding any refund to the household. The NCU Specialist will review each case and forward the information to DHCFP as necessary.

D-540.1 Converting to Institutional Eligibility

Do not terminate eligibility for individuals currently eligible under another medical group while institutional eligibility is being evaluated if they continue to meet eligibility criteria.

a. Evaluate current resources and compare to institutional resource limit. When the applicant is married (living separate or together), request the couples’ current resources and complete a spousal resource assessment.

Note: This step is not necessary when converting from home-based waiver category unless a change in resources is reported.

b. Evaluate current income. Do not request verification unless a change in income due to institutionalization occurs. Complete a spousal impoverishment determination if a community spouse is involved. If recipient is SSI eligible and payment has not been reduced to the $30.00 institutional level, notify Social Security using form 3911.