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UPDATED: NOVEMBER 2009
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OTHER ELIGIBILITY REQUIREMENTS
MAINTAINING MEDICAID ELIGIBILITY FOR INCARCERATED INDIVIDUALS
who are expected to be incarcerated at least 90 days who at incarceration have Coverage Code 09 (Medicare Savings Program) or Coverage Code 17 (COBRA, AHIP and third-party health insurance), because Medicaid payment of these premiums is not cost effective. However, Case Type 20 (MA) recipients with Coverage Code 09 who are participating in the spenddown program must have their case suspended and their premium payment discontinued.
NOTE: It may not be appropriate to discontinue health insurance premium payments if the policy covers other household members.
Medicaid and FHPlus must be discontinued with appropriate notice for recipients who are incarcerated out-of-state or in a federal penitentiary within New York State.
Incarcerated individuals who are released to the federal government, other state law enforcement, immigration or who are deceased must have their Medicaid discontinued with appropriate notice.
Re-Instatement of Medicaid
Upon notification from DOCS or a Local Correctional Facility that an individual whose Medicaid or FHPlus authorization had been placed in suspend status, and is being released to Parole or has completed his/her sentence without community supervision, Medicaid coverage must be re-instated in the district where the releasee had coverage immediately prior to incarceration. Coverage will begin on the first day of the release month and continue for the following four months.
Released to the Community Without Supervision
If a formerly incarcerated recipient who has been released to the community without supervision contacts the LDSS with a change of address, the LDSS must update the recipient’s address on WMS to ensure that the renewal packet will be mailed to the correct address. If the new address is in another district, the case must not be transferred to the new district until the five-month reinstatement period has expired, the renewal process has been (MRG)