MA606UU

Does the customer meet all other eligibility requirements, and is ineligible only because of prorated prizes or winnings income (MA606UU.2)?

• If YES, continue to step 2.

• If NO, STOP. Undue Hardship does not apply. Explain the prorated income policy and other policies that are not met to the customer.

Submit a Policy Clarification Request (PCR).

• In the body of the PCR, state that the customer is requesting an undue hardship exception to the prorated income policy in MA606UU.2.

• Provide the location of any proof supporting the claim in the case file. This may include any of the following:

  • Proof of the customer’s income at or below 100% FPL;

  • Proof of medically necessary services that would be the customer’s responsibility if AHCCCS Medical Assistance is not approved; or

  • Proof that the customer’s other benefits and insurance do not cover the customer’s needs.