Page 21

UPDATED: JANUARY 2011

475

OTHER ELIGIBILITY REQUIREMENTS APPLICATION, CERTIFICATION AND RENEWAL

NEW APPLICATION

or certified disabled, or not certified disabled is found eligible for Medicaid or FHPlus based on ADC-Related budgeting, eligibility cannot be denied based on the applicant’s failure to complete Supplement A. If an S/CC applicant is chronically ill and he/she failed to comply with a disability review or did not complete Supplement A, the applicant cannot be denied coverage if otherwise eligible for Medicaid under an S/CC budget or FHPlus.

If the LDSS believes that the applicant is the fiscal responsibility of another district, the LDSS where the individual is applying may take a “courtesy application” and forward it to the district of fiscal responsibility. The agreed upon district of fiscal responsibility shall obtain any information missing from the application.

NOTE: The date the first district received the application is protected as the date of application.

(See OTHER ELIGIBILITY REQUIREMENTS DISTRICT OF FISCAL RESPONSIBILITY (DFR))

Exception: When an applicant claims to have a disability or when it appears that an applicant may meet the criteria for disability, the district has 90 days from the date of application to make a determination of eligibility. This 90-day period is not used as a waiting period before granting assistance, if the applicant is eligible under a different category. Coverage is authorized as soon as eligibility is established. A note is made in the record as a reminder to re-budget the recipient, adjust any spenddown amounts and claim FP coverage for the retroactive period when the A/R is certified disabled. When it is necessary to hold a potential disability case beyond the 90-day period, this is not a basis for denying Medicaid to an otherwise eligible applicant or for terminating assistance.

(MRG)