Revision 15-4; Effective October 1, 2015

Advisors must make an eligibility determination by the 45th day from the file date.

Advisors reopen an application denied for failing to furnish information/verification if the missing information is provided by the 60th day from the file date. Use the date the missing information/verification was provided as the new file date.

Advisors use the original application until it is 60 days old.

If the information on the form has changed or is more than 45 days old, the individual and advisor must update the form.

Revision 10-2; Effective April 1, 2010

Provide Form TF-0001, Notice of Case Action, the same day eligibility is determined for an application but no later than 45 days from the file date.

 

Revision 10-2; Effective April 1, 2010

No interview is required to process an application or renewal unless requested by the applicant/individual. If requested, provide the applicant/individual a telephone interview. If the individual fails to keep the interview, do not deny the application or renewal but continue to process the request for assistance.

Revision 15-4; Effective October 1, 2015

Advisors may not request additional information or documentation from clients unless such information is not available electronically or the information obtained electronically is not consistent with the information provided by the client.

If additional information is needed, advisors must request documents that are readily available to the household and are considered to be sufficient verification. Each handbook section lists potential verification sources. C-900, Verification and Documentation, gives information on verification procedures.

In determining eligibility, advisors must consider any information the individual reports between the application date and the decision date. Include any information the individual reports during the application decision process.

Revision 15-4; Effective October 1, 2015

The system generates and sends renewal correspondence to individuals enrolled in Medicaid for Transitioning Foster Care Youth (MTFCY) following the process explained in B-121, Notice of Redetermination/Certification Expiration, for TP 08 and Children's Medicaid (TP 43, TP 44 and TP 48).

Note: The system will generate Form H1206, Health Care Benefits Renewal – MTFCY, rather than Form H1206, Health Care Benefits Renewal – MA, for individuals renewing MTFCY.

M—2161 How to Process a Renewal

Revision 15-4; Effective October 1, 2015

MTFCY recipients complete the administrative renewal process explained in B-122.4, Medical Program Administrative Renewals.

Note: If an individual is required to return a renewal form and returns a paper Form H1206, Health Care Benefits Renewal – MTFCY, the form is routed to Centralized Benefit Services (CBS) for processing.

Revision 15-4; Effective October 1, 2015

For individuals required to return a renewal packet, advisors must process the manual renewal as explained in B-122.4.2, Processing a Manual Renewal.

Revision 15-4; Effective October 1, 2015

Allow the household at least 10 days to provide missing information/verification. The due date must be a workday. Advisors must request documents that are readily available to the household if the documents are anticipated to be sufficient verification. If the applicant has any active or inactive Eligibility Determination Groups (EDGs), check to see if any verification previously provided for the other EDGs can be used to determine eligibility for MTFCY.

Use verifications accepted for the Temporary Assistance for Needy Families (TANF) program, Medical Programs or the Supplemental Nutrition Assistance Program (SNAP).

For example, if you accept wage verification for a SNAP case, that same verification is acceptable for TANF, Medical Programs or MTFCY.

Exception: Only Medical Programs sources of verification of U.S. citizenship for applicants can be used.

Note: Do not use verification that is over 90 days old from the MTFCY file date.

 

M—2181 Summary of Due Dates for Form H1020, Request for Information or Action

Revision 15-4; Effective October 1, 2015

Case Action	Due Date	Final Due Date
Application	10 days	30th day, or 10th day if the household's Form H1020 due date extends beyond the 30th day
Renewal	10 days	30th day or by cutoff in the last benefit month of certification, whichever is later; or 10th day if the household's Form H1020 due date extends beyond the last day of the last benefit month
Incomplete review	10 days	10th day

Note: Staff have until the 45th day from the file date to determine eligibility for applications.