Case Approved/Denied for Medicaid

6. The LO makes a final determination on the pending Medicaid application on 9/3. The PE period ends on 9/3.

When the worker authorizes the budget, if the household is not eligible for ongoing Medicaid, N-FOCUS will close the PE case effective 9/3 and reject the application for Medicaid programs. A Notice of Finding must be sent to the qualified provider to inform them that the PE period has ended and that further Medicaid coverage has been denied. The medical dates in this example would be 7/2 to 9/3.

Ineligible--Application Denied

7. The LO determines the household eligible for ADC/MA. The worker opens the pending ADC case.

The MA effective date for the ADC case is the first day of the month of request (7/1). The MA effective date for the unborn/child(ren) is also the first day of the month of request since there was ADC eligibility in July.

The MA date for the unborn/child(ren) must correspond to the ADC case (i.e. could be retro months and/or the first day of the month of ADC eligibility).

Eligible - Application Approved

(Rev. February 7, 2000)