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3.1.5 Program Changes at Renewal If health care coverage was maintained during a renewal and the member’s enrollment changes to a new health care program or has a reduction in their premium, liability, or cost-share, their eligibility may need to be redetermined for the month(s) that coverage was maintained. After a renewal is processed, if a member’s enrollment changes from a limited-benefit to a full benefit health care program, the eligibility in the new program may need to be redetermined for the months that coverage was maintained and any month in which the member may be eligible for the new health care program. After a renewal is processed, if the member becomes eligible for SLMB, SLMB+, or QDWI, their eligibility will be redetermined in the new MSP program retroactively back to the date their prior benefits were maintained. Normally, an individual cannot qualify for SLMB+ if they are enrolled in full-benefit Medicaid, but in this circumstance the overlap is allowed. Example 7 Tom is enrolled in MAPP and receives Medicare. The only Medicare Savings Program he qualifies for financially is SLMB+, but he is not enrolled because he has full-benefit Medicaid. His health care renewal is due in February. He submits a renewal on February 3. Verification is requested with a due date of February 23. Because his renewal was received timely, his MAPP coverage is maintained for March. Verification is received on February 19 along with a report that Tom is no longer meeting the MAPP work requirement. MAPP enrollment ends as of March 31 and Tom’s eligibility for SLMB+ begins on March 1. Example 8 Matt’s Institutional Medicaid is due for renewal in February. He submits a renewal on February 3. Income verification is requested with a due date of February 23. Because his renewal was received timely his Institutional Medicaid coverage and his patient liability from February are maintained for March. Verification is received on February 19 verifying an income reduction. Although Institutional Medicaid coverage was maintained through March, the income reduction was reported in February and verified timely, so his patient liability is reduced retroactively for February and March. Eligibility must be retroactively determined in situations where health care coverage was maintained for one household member and, after the redetermination of eligibility, another household member that was previously not eligible for health care is newly eligible. Eligibility is determined back to the date the change was reported. Example 9 John and his wife Julieta both applied for health care. Julieta was denied for being over assets for MAPP, but John opened for MAPP. John is due for renewal in February. On February 3 the renewal is submitted. Verification is requested with a due date of February 23. John’s MAPP coverage is maintained for March. Verification is received on February 19. A joint asset decrease makes both John and Julieta eligible for MAPP with a new certification period starting April.1. However, because the asset reduction was reported and verified in February, Julieta’s eligibility for MAPP is determined retroactively for February and March. This page last updated in Release Number: 26-03 Release Date: 08/12/2026 Effective Date: 08/12/2026 3.2 Administrative Renewals