323.7 Individual Whose Location Is Unknown

When the CAO receives returned mail, the CAO must:

1. 1. Check the case file, including Case Comments and Imaging for a new or a corrected address.
      • If the CAO can verify that the individual has reported a new address or identifies a correction to the existing address (such as a missing apartment number), the CAO will update the address and resend the mail to the new or corrected address.

1. 2. If there is nothing in the case file to indicate a change in address, or if the mail comes back as returned after the CAO sent it to the new address:
      • The CAO will attempt to contact the household by phone to confirm the address.
      • If the CAO confirms that the current address is correct and it has not changed, the CAO will enter a narrative in Case Comments and resend the mail that was returned.

1. 3. If the CAO is unable to reach the individual by phone, the CAO will send a PA 253 pending verification letter to the address on file requesting confirmation of the new address.  The CAO will also send a CACLET letter through the Correspondence Notice/Letter Generation module to the forwarding address if available on the returned mail with the request to confirm the address.

• • • If the individual confirms or provides an updated address, the CAO will update the case and complete appropriate actions.
    • If the individual does not confirm or provide an updated address by the due date on the pending letter, the CAO will take the following actions:  
    • If the United States Postal Service (USPS) provides an out-of-state address, close the case.
    • If the USPS provides an in-state forwarding address:

• If returned mail is received for information that is required to make an eligibility determination, such as a PA 253 for income or resources, the CAO will close affected MA budgets not subject to continuous eligibility.
• When returned mail is received for information not required to make an eligibility determination, such as an eligibility notice, letter, or ACCESS card, the CAO will keep MA budgets open and review the address at the next client contact or at the next renewal. The CAO will not enter the address in the system until confirmation of the address is received.

If the CAO closes the case but the individual confirms the address within the reconsideration period, the CAO will reinstate benefits with no gap in coverage and will complete an Inter-County Transfer if an address is in another county.

For cases that closed due to returned mail without a forwarding address, the CAO will reinstate MA with no gap in coverage if an address is confirmed prior to the individual’s originally scheduled renewal date. If the confirmed address is in another county, the CAO should complete an intercounty transfer.

323.71 Returned Mail at Renewal

• If an individual reports a change of address after the renewal packet is mailed, and the case is still open, the CAO will re-send the renewal packet to the new address. The CAO will allow 30 days to return the renewal and required information.

If a renewal packet is returned through the mail for a case for which the CAO completed an ex parte review and MA was renewed, the CAO will take the same steps outlined in Chapter 323.7 in steps 1 through 3.

If a renewal packet is returned through the mail before the CAO completes an ex parte review, the CAO will take the following actions:

• The CAO will attempt to confirm the address. If the CAO can confirm the address, the CAO will send the renewal packet to that address and allow 30 days to return the renewal and required information.
• If the CAO is unable to confirm the address with the individual, but a forwarding address is available on the returned mail, the CAO will re-send the returned renewal packet to the forwarding address without updating the forwarding address in the system and allow the individual 30 days to return the renewal and required information.
• The CAO will close MA for failure to provide information necessary to complete a renewal if the renewal was sent to the forwarding address and the renewal and required information are not received by the due date. If the renewal and required information are returned within the reconsideration period, the CAO will process the renewal and ensure there are no gaps in coverage for any affected eligible individuals. Note: The CAO must narrate in case comments all steps and actions taken.
• When a case has closed, and an individual reports a change of address during a reconsideration period for a case in which a renewal packet did not come back as returned mail and the CAO was not able to renew MA through the ex parte review conducted prior to termination for failure to provide, the CAO will reopen MA effective the date of contact and address confirmation. The CAO will re-send the renewal packet to the new address and give 30 days to return the renewal and required information. If the renewal and required information are not received by the due date, the CAO will close MA for failure to provide information necessary to complete a renewal. If the individual returns the renewal packet and required information, and remains eligible for MA, follow the current reconsideration policy.

• If a case with closed benefits receives a renewal back as returned mail during the reconsideration period, the CAO will: 

• • Check the case file, including Case Comments and Imaging for a new or a corrected address.
  • If the CAO can verify that the individual has reported a new address or identifies a correction to the existing address (such as a missing apartment number), the CAO will update the address and resend the mail to the new or corrected address.

• If there is nothing in the case file to indicate a change in address, or if the mail comes back as returned after the CAO sent it to the new address:
• The CAO will attempt to contact the household by phone to confirm the address.
• If the CAO confirms that the current address is correct and it has not changed, the CAO will enter a narrative in Case Comments and resend the mail that was returned. 

• If the CAO confirms the address, the CAO will send the renewal packet to that address and give 30 days to return the renewal and required information. The CAO will reopen MA starting the date of contact and address confirmation. If the renewal and required information are not received by the due date, the CAO will close MA for failure to provide information necessary to complete a renewal. If the individual returns the renewal and required information and remains eligible for MA, follow current reconsideration policy.

• If the CAO is unable to confirm the address but a forwarding address is available on the returned mail, the CAO will re-send the returned renewal packet to the forwarding address and give 30 days to return the renewal and required information. The CAO will not reopen MA until the individual contacts the CAO to confirm their address.

• When a renewal packet is received as returned mail and the CAO cannot confirm the address by using the case record and phone contact and there is no forwarding address, the CAO will enter a narrative in the Case Comments to document the completed review and will not take any further action.

Updated March 3, 2025, Replacing May 3, 2024