A new application (paper or electronic) is not required when benefits are closed and the individual requests that MA benefits be reopened, asks for a new application, and/or submits required documents within 60 days of the date MA benefits were closed. See Section 304.16, Where to Find a Form, and Who Does or Does Not Need One.
Example: MA budget closed on March 15, 20xx and the appropriate ineligibility notice was sent. Request for reconsideration is received within 60 days of the MA closure date but no later than May 13, 20xx.
Reminder: A new application is required if there is anyone new who wants to apply for MA or 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.
When an individual requests that benefits be reopened and/or submits required documents and it is within 60 days of benefits closure, reconsider the case using the paperwork and information in the case record on the date benefits were closed plus any paperwork or information the individual submitted after benefits were closed. Also review information available through electronic data sources. See Section 312.6 Verification and Section 378.6 Automated Sources. If eligible, reopen benefits effective the day after benefits closure.
If an application is submitted within 60 days of the date MA benefits were closed and the individual is eligible for MA benefits based on the information on file, information available to the CAO electronically, or information submitted by the individual, the CAO will reopen MA benefits effective the day after the date MA benefits were closed.
The CAO may have the individual complete a new application if it would expedite benefit delivery.
Example: A new application may benefit the individual if there are delays in locating or transferring previously completed documents from district to district or from county to county.
NOTE: A household may file an appeal as well as have a case reopened. Filing an appeal does not preclude reopening a case. Reopening a case does not preclude an appeal.
Although a new application (paper or electronic) is not required, the CAO must register a non-application in eCIS when the individual requests reconsideration, asks for MA to be opened, asks for a new application, and/or submits required verification.
NOTE: If the individual provides some but not all of the pending information, the CAO must work with the individual in an effort to get the required information.
A new application (paper or electronic) is not required to reopen MA benefits for incarcerated individuals in suspended status (MG99) upon their release. MA benefits will be reinstated once the CAO is notified that the individual will be/has been released. Notification of an individual’s release from incarceration may be received by contact from the individual or corrections facility, including: a telephone call, CAO visit, change center ticket, or Exchange 10 hit.
Updated October 4, 2018, Replacing December 3, 2015