159.01 Termination of Medical Assistance (MAM)

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Terminations are effective the last day of the ANP. Decreases in eligibility are effective the day after the ANP expires.

Exceptions:

·        EMA, MCPW 12 month Postpartum, QMB, SLMB/SLMB135, QDWI, In/Out MA, cases in a Temporary Adjustment Period, and 1619 certified individuals must close the last day of the month in which the ANP expires.

·        If categorically needy medical assistance is terminating due in whole or in part to an increase in  alimony, extend medical assistance for 4 months. Extend medical assistance only if there are no changes in the program criteria or nonfinancial criteria which make the individual ineligible at the same time as the increase in income.

·        If categorically needy medical assistance is terminating because of increased earnings or increased hours of employment of the principal wage earner, extend medical assistance for up to 12 months. Extend medical assistance only if there are no changes in the program criteria or nonfinancial criteria which make the individual ineligible at the same time as the increase in income or hours of employment of the principal wage earner.

·       Continue medical eligibility for up to a maximum of 4 months to categorically eligible refugee assistance groups when they become ineligible for financial or medical assistance because of new or increased income. Extend medical assistance only if there are no changes in the program criteria or nonfinancial criteria which make the individual ineligible at the same time as the increase in income. Close the refugee case for the four-month extended medical assistance effective the date on which their refugee eligibility period expires regardless of the length of time they received the extended medical assistance.

References: He-W 882.01, He-W 882.04; He-W 882.05; 45 CFR 400.104