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UPDATED: JANUARY 2011 530

OTHER ELIGIBILITY REQUIREMENTS STATE RESIDENCE AND RESPONSIBILTY FOR ASSISTANCE

ASSISTANCE TO PERSONS WHO CHANGE RESIDENCY

NOTE: Managed Care and FHPlus recipients who are receiving Guaranteed Coverage (Coverage Codes 31 and 36 respectively) have been determined to be ineligible for Medicaid. If such an individual reports a move to another district, the individual is entitled ONLY to the balance of the six month guarantee from the original county of residence.

Third Party and Medicare- When a case opens in the new district of residence, any commercial insurance, Medicare coverage and Medicare Savings Program information must be reflected on eMedNY.

If the former district of residence has been paying a commercial health insurance premium, all necessary information regarding the payment of the premium must be forwarded to the new district of residence and annotated on the Relocation Referral Form.

The new district of residence should verify that the commercial policy remains in effect. Any changes to coverage or providers should be entered in the eMedNY Third Party subsystem and the district should assume the responsibility of making the premium payments. This should be done timely to ensure the commercial health insurance coverage is not jeopardized.

CITIZENSHIP DOCUMENTATION- For cases where the Social Security citizenship verification match confirmed citizenship, the worker must note this on the “Relocation Referral Form” which is forwarded to the new district. If the worker verified citizenship through documentation provided by the A/R or a referral to Vital Records, a copy of the verification received shall be forwarded to the new district. If an individual has not yet provided citizenship documentation or authorization for the district to confirm birth information with Vital Records, the case must be transferred to the new district, and the new district must pursue such documentation/authorization. The originating district shall note any outstanding issues concerning a recipient’s citizenship/identity documentation on the referral form sent to the new district.

Disposition: Local Social Services Districts must ensure that individuals who report their move to a new district and are otherwise eligible have their Medicaid/Family Health Plus case transitioned to such new district. Appropriate and timely transactions in the Welfare Management System (WMS) must be made, and coordinated between the new and former districts to ensure appropriate access to Medicaid and Family Health Plus coverage. (MRG)