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UPDATED: JUNE 2011

485.1

OTHER ELIGIBILITY REQUIREMENTS APPLICATION, CERTIFICATION AND RENEWAL

RENEWAL

Care or Medicaid coverage of institutional based nursing facility services respectively, must document income and resources including resource documentation for the full transfer of assets look back period for coverage of institutional-based nursing services.

Supplemental Security Income (SSI) recipients that lose eligibility for such benefits are given an extension to allow for continued Medicaid eligibility to be determined. If the former SSI recipient is in receipt of Community-based Long-term Care services he/she must document income and resources as part of the redetermination process. At subsequent renewals, the individual is allowed to attest to income and resources.

All SSI cash recipients who enter a nursing facility and appear on the SDX with a "Pay Status Code" of EO1 (eligible - no payment) are sent a letter by the district informing them of their continued eligibility for Medicaid. In addition, the income of these individuals is reviewed to determine the amount, if any, of their net available monthly income (NAMI) to be contributed toward the cost of care.

NOTE: Documentation of income, residence and resources, as appropriate, at initial application is still required for ALL applicants.

(MRG)