Page 15

25.6.4 Federally Facilitated Marketplace .............................................................................................. 205 25.7 Application Processing Period ........................................................................................................... 205 25.7.1 Multiple Application Submission ............................................................................................... 206 25.8 Begin Dates ....................................................................................................................................... 206 25.8.1 Begin Dates Introduction ........................................................................................................... 206 25.8.2 Backdated Eligibility ................................................................................................................... 206 25.8.2.1 Backdated Eligibility Timeframe ......................................................................................... 207 25.8.2.2 Determining Backdated Eligibility ....................................................................................... 207 25.8.2.3 Medical Bills During Backdated Eligibility Period ................................................................ 208 25.8.2.4 Family Planning Only Services ............................................................................................. 208 25.8.2.5 Pregnant Members ............................................................................................................. 208 25.9 Denials and Terminations ................................................................................................................. 209 25.9.1 Termination ................................................................................................................................ 209 25.9.2 Denial ......................................................................................................................................... 210 26.1 Renewals ........................................................................................................................................... 211 26.1.1 Timely Renewals ........................................................................................................................ 211 26.1.2 Late Renewals ............................................................................................................................ 212 26.1.3 Late Verification for Renewals ................................................................................................... 213 26.1.4 Gaps in Coverage ....................................................................................................................... 213 26.1.5 Program Changes at Renewal .................................................................................................... 214 26.2 Administrative Renewals .................................................................................................................. 214 26.2.1 Administrative Renewals Introduction ...................................................................................... 214 26.2.2 Administrative Renewal Selection Criteria ................................................................................ 215 26.2.3 Administrative Renewal Process ................................................................................................ 215 26.2.3.1 Successful Administrative Renewals ................................................................................... 215 26.2.3.2 Unsuccessful Administrative Renewals .............................................................................. 216 26.2.3.3 Change Reporting After Administrative Renewal ............................................................... 216 26.3 Redetermination for Changes ........................................................................................................... 216 26.3.1 Changes in Circumstance ........................................................................................................... 217 26.3.1.1 Time-Limited Benefits ......................................................................................................... 218 26.3.1.2 Children in Continuous Coverage Periods .......................................................................... 218 26.3.1.3 Other Health Care Programs ............................................................................................... 218 26.3.2 Member Transition to Disability ................................................................................................ 218 26.3.3 Program Changes ....................................................................................................................... 219 26.3.4 Redeterminations when Foster Care Medicaid Ends ................................................................. 220