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101 (07/2026) Chapter 2:Eligibility • Section 1: Application The effective date for restoring benefits that have been suspended is: • The first of the month after the suspension, if the suspension was for only one month, or • The date the benefit group again becomes eligible, if benefits have been suspended for more than 30 days. Treat the month in which benefits are restored as an initial month. Denial of benefits The effective date for denying benefits is the date the decision is made that the individual is not eligible, including if the ineligibility results from failure to provide information or otherwise cooperate. Closure and suspension of benefits When the only individual in a benefit group dies, the effective date of closure is the date of death. If there is more than one person in the benefit group, the date of death is the date of reduction in benefits. When using prospective budgeting, the effective date for closing or suspending benefits is the last day of the month in which the notice period ends. For a pregnant person receiving OSIPM, the effective date for closing benefits is no earlier than the last day of the 12th calendar month after the last day of pregnancy falls, except at the individual’s request. The effective date for suspending medical benefits due to incarceration is the day following the date on which the individual becomes incarcerated Medical can only be retroactively closed in the following scenarios: • Death • Incarceration Note: There are specific scenarios where additional retroactive closures may be permitted, which are outlined in the Retroactive Closures for Medical Eligibility Guide. Some scenarios may be approved by a Lead, whereas some scenarios require Policy approval. As of January 1, 2026, medical cannot be retroactively closed when the Department did not act on a timely report of an out-of-state move. Continuous eligibility (CE) CE Periods are established once all Requests for Information (RFIs) are cleared at intake, renewal, or when an individual is moving from a program ineligible for CE to a program eligible for CE. Click here for more on effective dates for long-term care (LTC) services. HSD New applicants: The effective date of benefits is the earliest of the following: • The first day of the month in which the date of request is established, or • If ineligible in the month of the date of request, the first day within the following month the applicant is determined to be eligible.