157.05 Processing Redeterminations SR 13-35, 10/13 (MAM-A)

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 DFA Form 800, Application for Assistance, DFA Form 800MA, Application for Health Coverage & Help Paying Costs, or Form 800HR, New HEIGHTS-generated Application for Assistance, provide all needed proofs, if required, and participate in a face-to-face interview, if the redetermination method is face-to-face;

• return the completed DFA Form 800R, Application for Continued Eligibility for Financial, Medical, Child Care, and Food Stamp Benefits, or DFA Form 800PR, Renewal Application For Children’s Medicaid (CM) and Medical Coverage for Pregnant Women (MCPW), and provide all needed proofs, if the redetermination method is mail-in. No interview is necessary if participating in the mail-in redetermination process; or

• complete the online Redetermination Application and provide all needed proofs, if the redetermination method is online. No interview is necessary if participating in the online redetermination process.

When verification is not sufficient or not provided in the online or mail-in redetermination process:

• send New HEIGHTS-generated AE0055, Proof Needed to Determine your Assistance. Or, if New HEIGHTS is unavailable, use paper backup DFA Form 808, Proof Needed to Determine Your Assistance; and

• allow individuals 10 additional days to provide the needed verification.

Require face-to-face interviews with individuals who do not fully complete either DFA Form 800R, DFA Form 800PR, or the online Redetermination Application, but at a minimum provide their name, address, and sign the form.

Contact the individual to ensure information has not changed since the redetermination appointment if the case is not being processed within one month of the appointment date.

Process redeterminations within 30 days of the application date if the individual has not participated in an interview or provided required verification by the end of the certification period.

Policy about processing redeterminations will change under the Affordable Care Act (ACA). This policy will be updated to incorporate these changes at that time.