Page 444

annual income. The reduction in annual income may occur for various reasons, such as loss of income, divorce, marriage, institutionalization or death of a spouse, or any other change that results in a significant decrease in income . This could result in SeniorCare eligibility at a lower income level resulting in a reduction/elimination of spenddown or deductible. To reapply, members must submit a new application form and pay a $30 enrollment fee per person. Eligibility will be redetermined for a new 12-month period (within 30 days) after a complete application is received. When eligibility for a new benefit period is determined, the member's previous benefit period is terminated, and they are not allowed to restart the previous benefit period. Any expenses applied to the previous benefit period will not be applied to the new benefit period. Eligibility for a new benefit period begins on the first day of the month after a complete application is received and all eligibility requirements are met. This page last updated in Release Number: 26-03 Release Date: 08/12/2026 Effective Date: 08/12/2026 33.12 SeniorCare Early Termination 33.12.1 SeniorCare Early Termination SeniorCare eligibility is terminated prior to the end of the established benefit period if: 1. A member no longer meets non-financial eligibility requirements, or 2. They request to withdraw from the program, or 3. They request to establish a new benefit period and eligibility for the new benefit period is confirmed (see SECTION 33.11 RE-APPLICATION). When SeniorCare eligibility has been terminated prior to the end of the established benefit period and the SeniorCare program is notified that all eligibility requirements are again satisfied, within one calendar month of SeniorCare eligibility termination, the benefit period is restored. Exception: SeniorCare members who lose SeniorCare eligibility solely due to receipt of Medicaid benefits do not have their benefit period terminated; however, they are not eligible for SeniorCare benefits or services for the calendar months that they receive Medicaid benefits. If Medicaid eligibility ends prior to the end of the SeniorCare benefit period, and the member is still SeniorCare eligible, SeniorCare eligibility automatically resumes. Example 1 Amy applies for SeniorCare on October 4th and is determined eligible effective November 1st. In December she applies for Medicaid and is determined eligible, effective December 1st. Amy is not eligible for SeniorCare benefits or services while she is receiving Medicaid. In January, Amy inherits $5,000 and is notified that her Medicaid eligibility ends January 31st, because her assets exceed the limit. Amy still meets SeniorCare eligibility requirements, so SeniorCare eligibility will resume from February 1st through October 31st. See SECTION 33.15 ANNUAL ELIGIBILITY REVIEW for termination as it applies to the need for an annual review.