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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL Division of Welfare and Supportive Services D-540 Medical Assistance Manual CHANGES 24 Jan 25 MTL 02/24 CONVERSIONS D-540 CONVERSIONS

During a period of eligibility, there may be changes in case circumstances where another category of eligibility must be evaluated. Converting between categories does not require a new application but may require additional forms to be completed or information to be gathered by the case manager. When converting to an equivalent category, i.e., home based waiver to institutional, do not request additional information unless a change in income or resources is reported.

When converting a case to a new aid code, ensure the action is taken prior to cut-off. Actions taken after cut-off for the next month do not update in the MMIS system.

The following types of conversions identify procedures required to re-evaluate factors of eligibility.

Expanded eligibility under the new adult group (AM1 and CA) is an optional group which must be considered only after all mandatory groups are evaluated. When a recipient is eligible under this group and they become institutionalized, they must be evaluated under the institutional group; if not eligible under institutional, they can remain eligible under AM1 or CA.

Customers with ongoing CA or AM1 Medicaid cases who attain age 65 and/or become entitled to enroll in Medicare must be terminated from that coverage group allowing adverse re-evaluated for MAABD eligibility.

Persons who are eligible for Medicare include:

a. All persons over age 65 who are either U.S. citizens or a non-citizen lawfully

admitted for permanent residency who has resided in the U.S. continuously 5

years immediately preceding the month they apply for Medicare.

b. Person under age 65 who have received monthly Social Security/Railroad

Retirement disability benefits for 24 months.

c. Persons with chronic renal disease.

Exception: Use the following steps when converting a Nevada Check-Up (NCU) case to another Family Medical aid code or to a MAABD program: 1- Nevada Check-up to Family Medical

a. Initiate a REHA in the appropriate footer month based on the reported change. The REHA action will instruct the system to evaluate all family medical programs for each individual in the household.

b. The conversion of eligibility is effective the first administrative month after the month in which the action was taken. An administrative month requires all case actions be completed prior to cut-off. If the REHA action is done after