601.02.01 Definitions

Application Month | The month in which an applicant applies for Presumptive Eligibility. Following Month | The month directly following the Application Month. Full Application Form | This application is the Healthy Connections Application, Form 3400, and should be completed by an applicant for an eligibility determination regarding full Medicaid benefits. Presumptive Eligibility Application | The Medicaid Presumptive Eligibility Application, Form 3402, is a modified version of the Healthy Connections Application, and should be completed by an applicant for an eligibility determination regarding Presumptive Eligibility. Presumptive Eligibility Period | The period that begins on the date on which a qualified entity determines that an applicant is presumptively eligible and ends (whichever is earlier): (1) For an applicant who has filed a Medicaid application and is found eligible for regular Medicaid, the day on which a decision is made on that application; or (2) For an applicant who has not filed a Medicaid application, the last day of the month following the month in which the determination of presumptive eligibility was made. Presumptive Income Standard | The highest income eligibility standard established under the plan that is most likely to be used to establish the regular Medicaid eligibility of an applicant. Qualified Hospital | A type of Qualified Entity that - (1 ) participates as a provider to make presumptive eligibility determinations consistent with St ate policies and procedures, (2 ) assists individuals in completing and submitting the PE application and understanding any documentation requirements, and ( 3 ) has not been disqualified by SCDHHS.