MA eligibility begins:
The date when the CAO gets and stamps a signed application form.
The earliest date the application is signed by the applicant if it is submitted by an MA provider or at any site chosen by the Department of Human Services (DHS).
The date a COMPASS application is submitted online.
The date of first treatment or admission if the COMPASS application is submitted by an MA provider.
The date the application was submitted to the Federally Facilitated Marketplace FFM if the application is forwarded to the CAO from the FFM.
Eligibility ends on the date the individual no longer meets the eligibility requirements.
A child born to a woman who is receiving MA or CHIP on the date of the child's birth automatically receives MA coverage for one year. (See Section 309.32, Adding a Newborn to an MA Household).
An individual can apply for benefits for medical services in the past if he or she has an unpaid medical expense from before the application date. Benefits for past medical services may be approved for the period starting with the first day of the third month before the date of application. The individual may choose to apply for either (a) retroactive-only, (b) continuing-only, or (c) combined retroactive and continuing MA benefits.
Eligibility ends on the date the individual no longer meets the eligibility requirements.
Individuals may be eligible for a 4 month extension of MA under TMA if all of the following criteria are met:
The individual was eligible in a PC/PU 27, MG 27 or C/U budget for 3 out of the last 6 months (not including the closing month).
The individual meets the target criteria to be eligible for MAGI-related MA (requesting MA as a parent/caretaker or child, with the dependent child still in the household).
The individual is ineligible for MG 27 or C/U due to an increase in earned income, alimony or spousal support
TMA is authorized as MG 71, effective the processing date of the income change. A renewal is due at the end of the 4th month (not including the month of change).
Example: On January 6th, an income increase is processed on an MG 27 case and causes net income for the household to increase above the MG 27 limit. The household members have been eligible for MG 27 for 3 or more of the past 6 months and still meet MAGI target criteria, TMA is explored and MG 71 is opened effective January 6th. The renewal date is set to May 31st.
At renewal, a TMA recipient will be reviewed for other MA eligibility besides TMA. An individual can have multiple periods of TMA in a lifetime depending on changes in income, but there are no consecutive TMA periods.
Updated May 19, 2016 Issued September 19, 2014