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1169 (07/2026) Chapter 8: Examples • Chapter 8: Examples Example 2: An individual applies for and establishes a DOR for OSIPM on December 10. It is determined that the individual is ineligible on the DOR but meets all eligibility requirements on December 20. OSIPM eligibility begins on December 1. Example 3: An individual applies for and establishes a DOR for OSIPM on December 10. It is determined that the individual is ineligible on the DOR but meets all eligibility requirements on January 5. OSIPM eligibility begins on January 1. Example 4: On October 5, Jenny applies for OSIPM. Jenny receives SSI, SSD and Medicare. Jenny has unpaid medical expenses in July, August and September. Jenny is interviewed on October 11 and is found eligible for OSIPM. Jenny asks for help with unpaid medical bills and is found eligible and approved for retroactive medical in each of the three months prior to the DOR. Ongoing eligibility begins October 1. Example 5: On February 10 an individual applies for their deceased husband. Their spouse passed away on December 15 in Salem Hospital. He had suffered a heart attack and was in the hospital from December 3 until his death. He was an SSI recipient, but had never applied for Medicaid. The individual wants Medicaid to pay for their spouse’s hospital costs. Since the husband was Medicaid eligible at the time of hospitalization (receiving SSI), and the date is within 3 months of the Date of Request, we would cover his hospital expenses by approving retroactive OSIPM for December 1-15. The application process Multi-program example 1 Gena submits her application with DOR of 10/15; Filing of 10/20. She completes her SNAP, TANF, medical, and ERDC interview on 10/20. She is applying on behalf of herself, her 11yr old daughter and 10yr old son. Her part time job is ending on the 21st; It is determined that she is over income for TANF and is denied Oct benefits. She is pended for additional information for SNAP and ERDC. She requests a new interview for TANF on 11/3. She brings her pended information for SNAP and ERDC to the TANF intake on 11/3. The worker determines that Gena is eligible for SNAP, ERDC, medical and TANF SNAP Gena completed the application process by establishing a filing date, completed an interview, submitted needed verification for eligibility and cleared eligibility. TANF Gena can establish a new filing date by resigning her 415F in the month of Nov. Gena’s previous interview on 10/20 would have exceeded 10 calendar days from her new filing date on 11/3, therefore she would be scheduled a face-to-face interview to determine eligibility unless she meets the hardship rule for a phone interview.