A new application (paper or electronic) is not required when benefits are closed and the individual requests that MA LTC services be reopened, ask for a new application and/or submits required documents within 60 days of the date benefits were closed.
The CAO must re-determine eligibility using the paperwork and information in the case record on the date benefits were closed as well as any paperwork or information the individual submitted after benefits were closed. Always review information available through electronic data sources. If eligible, reopen MA LTC services effective the day after benefits closure.
Example: LTC/HCBS closed on March 15, 20xx and the appropriate ineligibility notice was sent. Request for reconsideration is received within 60 days of the LTC/HCBS closure date but no later than May 13, 20xx.
Reminder: Timely appeals of a closure notice will ensure continuous coverage. Appeals and reconsiderations can be requested concurrently and if resolved, unnecessary appeals will be withdrawn.
A new application is required if the benefits were closed because the applicant(s) was over the income and/or resource limit unless the applicant(s) subsequently provides verification that they were within the allowed income and/or resource limits at the time of closure. Although a new application is not required for reconsideration, the CAO must still register a non-application in e-CIS when the individual submits all required verification.
NOTE: If the individual provides some but not all of the pending information and the closure was appealed, the CAO must continue to work with the individual to obtain the necessary information. New information provided will be reviewed prior to an appeal hearing.
Updated December 4, 2015 Reissued October 9, 2015, replacing August 14, 2015