155 REDETERMINATION SR 04-04, 05/04 (AAM-A) |
Redetermine eligibility for all individuals at regularly scheduled intervals.
Schedule redeterminations at least every 12 months. See PART 127, LENGTH OF ELIGIBILITY.
Exception: If the case involves multiple programs of assistance, redetermination periods for all programs are aligned to coincide with the most frequent redetermination required by policy.
To prevent delays in the redetermination process, the individual must do the following by the 15th day of the last month of the redetermination period:
• complete and return Form 800R, Review for Continued Eligibility for Financial, Medical, and Food Stamp Benefits, no interview necessary, if eligible for the mail-in redetermination process. See PART 121, INTERVIEWS, and Section 155.01, Timely Notice;
• complete and return Form 771a, Nursing Home Redetermination, no interview necessary, if residing in a nursing facility or swing-bed hospital or only eligible for medical services other than payment for nursing facility care; or
• complete Form 800, Application for Assistance, or Form 800HR, HEIGHTS-generated Application for Assistance, and participate in a face-to-face interview.
Exception: QMB, QDWI, SLMB, and SLMB135 redeterminations for New Hampshire Housing Authority (NHHA) residents, or individuals who have been assisted with the application process by a trained volunteer counselor from Health Insurance Counseling, Education, and Assistance Services (HICEAS), may continue to be submitted on Form 800Q, Assisted Application For Help With Medicare Costs For Medicare Beneficiaries.
Review and verify all eligibility factors and criteria subject to change. Update eligibility and benefits, as necessary.