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Selected Eligibility Cross Pathways By Population (Excludes beneficiaries eligible on basis of other programs) Population MACC Group – MAGI-Based (No Retroactive Coverage) IHCC Group SSI methodology- based (Retroactive Coverage Possible) Both MACC and IHCC Eligibility determined using both Elders Only if a parent/caretaker EAD, MPPP, MN Sherlock Plan if working LTSS Option MACC group for parents/caretak ers and MPPP 3. Continuing Eligibility Reviews Prior to Termination of Coverage – The State must evaluate whether a beneficiary may qualify for Medicaid health coverage through an alternative pathway prior to the termination of eligibility. This requirement only applies when the reason for the termination is a change in an eligibility factor (e.g., age, income, resources or disability, relationship, etc.). The State uses any information known about the beneficiary through their account and electronic data sources to evaluate the options for continuing coverage. A beneficiary is informed in writing about this evaluation, which is referred to as an ex parte review, and of any additional materials that must be submitted to determine whether alternative forms of eligibility exist at least ten (10) days prior to the date the eligibility termination takes effect. Such notification is provided more than thirty (30) days in advance of the date of the agency action whenever feasible. In addition to evaluating beneficiaries for other forms of Medicaid eligibility, anyone under age sixty-five (65) is also considered for commercial coverage with financial help through HSRI. 2.9 Renewal of Eligibility for IHCC Groups 2.9.1 Scope and Purpose A. One of the principal requirements of Medicaid is that continuing eligibility must be re-evaluated at least once per year. For the IHCC groups, this annual review was called a “redetermination” and, accordingly, often required beneficiaries to