121 INITIATION OF MEDICAL ASSISTANCE (MAM)

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Medical assistance begins on the date of application if all eligibility requirements are met. Applications are made using DFA Form 800, Application for Assistance, DFA Form 800MA, Application for Health Coverage & Help Paying Costs, or DFA Form 779, Application for Retroactive Medical Assistance.

Exceptions:

. Children's Medicaid (CM) 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.

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

. Medical assistance for individuals eligible using the life insurance offset begins on the specific day of the month that life insurance, minus incurred unpaid medical bills, plus other resources, are equal to or less than the resource limits, providing all other eligibility requirements are met.

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

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See PART 177, PRESUMPTIVE ELIGIBILITY (PE), for information on initiation of PE medical assistance.

References: He-W 680.01-He-W 680.02; RSA 167:10, 42 CFR 435.911, 42 CFR 435.912, 42 CFR 435.1200(e)