123.01 Initiation of Medical Assistance SR 99-36, 06/99 (FAM-A)

Medical assistance begins on the date of application if all eligibility requirements are met. Applications are made using Form 800, Application, Form 800H, HEIGHTS Application Form, Form 800P, Application for New Hampshire Healthy Kids Medical Insurance or Medical Coverage for Pregnant Women, or Form 779, Application for Retroactive Medical Assistance.

Exceptions:

• Healthy Kids-Gold medical coverage for newborns begins on their birth date, if all eligibility factors are met on that date.

• Medical assistance for recipients of Refugee Medical Assistance and 1619 certified individuals begins on the first of the month in which all eligibility requirements are met.

• Medical assistance for an individual being added to an existing group begins on the date on which the individual meets all eligibility factors.

• In and Out medical assistance begins on the day of the month on which the spenddown is met. See Part 617, In and Out Medical Assistance.

• Medical assistance for individuals being released from a public institution begins on the date of their release.

• Medical assistance can be retroactive up to 3 months preceding the application date when permitted by policy.

• Individuals found presumptively eligible for Healthy Kids-Gold medical coverage (HKG-185 or HKG-300 only) or Medical Coverage for Pregnant Women must be opened for benefits within 5 days of receipt of Form 800P by the District Office, unless, upon review, the District Office determines that:

- The presumptive eligibility decision was in error, or

- The individual has had consecutive presumptive eligibility determinations without an intervening period of receipt of medical assistance for which the District Office has conducted a full eligibility determination and verified all pertinent eligibility criteria.