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111 (07/2026) Chapter 2:Eligibility • Section 1: Application If benefits are reinstated after the individual’s renewal date, eligibility must be redetermined immediately after reopening. Note: An application may be needed if an individual is being restored on a new case, a full redetermination is required, and we do not have a previous signature on file. • The individual is currently receiving OSIPM, QMB, SMB, or SMF and eligibility is being redetermined:
Redetermination includes annual renewals, applicant-initiated requests for additional benefits, and reported or discovered changes that require redetermination of eligibility.
ODHS|OHA must have sufficient evidence using the existing application and be able to gather any additional information needed during the interview, if one is needed. • The individual was receiving OSIPM or an MSP, was terminated for failure to provide requested information during a periodic redetermination, and the requested information was received within 90 days of the termination. • When current OSIPM or MSP recipients request services. HSD A new application is not required in the following circumstances: • The Agency determines an applicant is not eligible in the month of application and:
Is determining if the applicant is eligible the following month, or
Is determining eligibility for retroactive medical • When benefits are closed and reopened during the same calendar month, • The individual’s medical benefits were suspended during incarceration, the individual is no longer a resident of a public institution, and ODHS|OHA learns of the change within 12 calendar months. If benefits are reinstated after the individual’s renewal date, eligibility must be redetermined immediately after reopening, Note: An application may be needed if an individual is being restored on a new case, a full redetermination is required, and we do not have a previous signature on file. • At renewal (eligibility may be automatically renewed, with or without an RFI, based on information on the case. If eligibility cannot be automatically renewed, an “Active Renewal” is sent, requiring a response with a signature, but this is not a full application), • When an individual’s coverage is set to terminate but the individual requests a new determination during the timely notice period before their coverage actually closes, • During the 90-day reconsideration period for eligibility following closure. The Agency will redetermine the eligibility of an individual who lost HSD medical program eligibility because they did not return the Active Renewal form or did not respond to an RFI if the renewal form or the RFI response is submitted within the 90-day reconsideration period. This will establish a new date of request. Click here for examples: When to use an application.