The NCE is a limited period benefit. It is normally limited to 31 days of coverage, but may be extended:
To issue retroactive benefits.
To provide benefits authorized to correct an administrative error or delay.
To meet the requirements of a hearing decision.
The NCE is used in the following situations:
MAGI MA and NMP eligibility ending in the month the opening is data entered.
NMP Spend-down eligibility determined monthly.
Retroactive MAGI MA, NMP or MNO eligibility for any or all of the three calendar months prior to the month of application.
NOTE: For all categories the NCE open date may be no more than 365 days prior to data entry. A ServiceNow ticket must be submitted to authorize an NCE beyond this period.
Retroactive MAGI MA, NMP or MNO beginning the first day of the month and ending the day before the date of application.
The NCE transaction opens the budget and closes the budget in one action.
The following data is required for the NCE transaction:
An open date (first day of eligibility).
A close date (last day of eligibility).
Information to identify each individual included in the budget group.
Other information required by eCIS.
NOTE: No renewal or SAR date is calculated by eCIS for an NCE.
The NCE authorization posts a benefit eligibility period in eCIS that is used to verify eligibility for medical services.
The NCE authorization will automatically issue an ACCESS card for an individual in the NCE budget in the following situations:
New individuals who do not have Individual (Recipient) Numbers.
Inactive individuals who have not been issued ACCESS cards prior to NCE opening.
The NCE authorization will not automatically issue an ACCESS card for an individual in the NCE budget in the following situation:
Inactive individuals who were previously issued an ACCESS card.
The CAO will explore the need for an ACCESS card and issue a replacement if necessary in the eCIS Standalone Module.
Examples:
Dan Brown applies for MA on 1/29. Dan presents verification of unpaid hospital and doctor expenses incurred on 10/20, 12/1 thru 12/7, and 1/3. The CAO determines that Dan is eligible for MNO based on a six-month period of October through March. Dan is requesting coverage only for October, December, and January. Two periods of eligibility will be authorized: one will be from 10/1 thru 10/31 and the other will be 12/1 thru 1/31. Dan has an ACCESS card as Dan was on MA prior to this period. No ACCESS card will be issued when MA is authorized.
Eric and Monica Parks apply for MA on 1/29. They present verification of hospital and doctor expenses incurred on 12/5 -12/10 and 12/20 - 12/22. The CAO determines that they are eligible for MNO for a six-month period of December through May. They are requesting coverage only for December to pay the incurred bills. The eligibility period authorized will be 12/1 thru 12/31. An ACCESS card is issued to Eric when the NCE period is authorized as Eric is a new individual without an individual number. No ACCESS card is issued to Monica as Monica received an ACCESS card when Monica was authorized for a prior period of eligibility.
Updated July 24, 2024 Replacing May 30, 2024