1311 Processing Applications for Multiple Months

Revised 06/14/2018

Policy

When determining eligibility for an application, more than one month may need a determination. Determine each month up through the current calendar month separately, using the actual household situation and monthly income or monthly equivalent for each month.

A customer’s situation may change from month to month. Since eligibility is determined on a monthly basis, a customer may qualify for one month but not another.

When a customer does not qualify for MA in a past month, but qualifies in the current month, a new application is not needed.

Each month the customer qualifies for MA is approved. Any months the customer does not qualify for MA are denied.

 

Definitions

Term	Definition
Denial	A denial is a determination that a person is not eligible for Medical Assistance benefits.
Monthly equivalent	The MA programs that use MAGI income rules may prorate some income over more than one month: Income received less often than monthly (see MA604D) Regular seasonal or contract income that is not received during the entire year (see MA604F)

 

Legal Authority

Program	Legal Authorities
All programs except KidsCare and QMB	42 USC 1396a(a)(34) 42 CFR 435.915