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UPDATED: JANUARY 2012

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OTHER ELIGIBILITY REQUIREMENTS APPLICATION, CERTIFICATION AND RENEWAL

RENEWAL

Description: A recertification/renewal for Medicaid is a review of current eligibility factors to determine whether to continue, change or discontinue Medicaid based upon the eligibility of the recipient.

All active Medicaid cases, including those receiving both Medicaid and Temporary Assistance, are recertified periodically. Generally, the recipient must submit a written renewal (recertification) to continue Medicaid. The re-authorization period may not exceed one year.

Policy: Each month, the district/State produces reports of cases due for renewal, generally at least 60 days prior to the date coverage expires. Based on the district’s entry of the appropriate code in the Client Notices System (CNS), a renewal package is produced and mailed to the recipient, or districts may opt to have the State automatically generate the renewal package through a one-time entry in the AFA field on WMS. This process is described in a WMS/CNS Coordinator Letter dated November 1, 2004.

The renewal package advises the recipient that coverage is expiring and explains the need for the recipient to provide current information and, in some cases, documentation to the local district. The deadline for returning the renewal form and the return address are included. It is the responsibility of the recipient to return the renewal form and the required documentation to the local district by the deadline provided.

Prior to September 1, 2011 the signatures of all adults applying for Medicaid/FHPlus were required on the renewal form. Effective September 1, 2011, only the signature of one applying adult is required on the renewal form.

NOTE: The renewal form for community cases, except for FPBP cases, contains pre-printed information from the Welfare Management System (WMS). It provides space for the recipient to amend the pre- printed information and provide new information, when appropriate.

Effective January 1, 2012, SSI-related single individuals and couple households with fixed incomes and whose resources are less than 85% of the Medicaid resource limit at application or last renewal whichever is later will have their case automatically renewed by the State. Such cases include SSI-related individuals or married couples 18 years of age or older with an Individual Categorical Code of Aged, Blind or Disabled, a Budget Type of SSI-related, Social Security as the only source of income and resources at or below 85% of the applicable Medicaid resource limit. Cases not included: Medicare (MRG)