312.3 Period of Eligibility

312.31 Ongoing Coverage

Medical Assistance (MA) Fast Track Enrollment Enhancements, OPS170805 (Published August 30, 2017)

 

MA eligibility begins:

 

 

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 309.2, Newborn Eligibility).

 

312.32 Retroactive Coverage

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.

 

NOTE: When processing a combined retroactive and ongoing MA application, the CAO should not delay processing ongoing MA while waiting for verification that is needed for retroactive MA.

 

Eligibility ends on the date the individual no longer meets the eligibility requirements.

 

NOTE: There is no spend-down for MAGI MA determinations. 

 

Updated January 13, 2025 replacing April 17, 2024