Effective Date: May 1, 2016

Previous Policy

Reporting Requirements

UPP recipients are not required to report changes in income during the 12 month certification period. However, if an income change is reported by the recipient or when the eligibility worker becomes aware of the change through another reliable source, only act on the information when the recipient requests a Medicaid determination or asks for a new income determination or the reported change is an exception to the 12 month enrollment period. See 1008 .

Increase in Income

Do not re-determine income eligibility if income increases during the certification period. Consider any changes in income at the next regular review.

Decrease in Income

R equest for a Medicaid Determination : When the recipient requests a Medicaid determination for any member of their household, including individuals who do not qualify for UPP, and the reported change makes the recipient eligible for Medicaid without a spenddown, or MWI premium; remove the Medicaid eligible individual/s from UPP and open Medicaid.

A ll factors of eligibility must be determined for all household members. See section 1004 to determine countable income.

If verification is needed to determine eligibility, give the member at least 10 days from the date of the notice to provide verifications .

No Request for Medicaid Determination : If the recipient does not request a Medicaid determination, or a new income determination, continue UPP until the end of the current certification period, even if the reported changes result in potential Medicaid eligibility for household members. Make any changes at the next UPP recertification.