Presumptive Eligibility Process

468-000-331 469-000-320 477-000-318 479-000-315

Form MS-91 is used by the Local Office to establish a presumptive case on N-FOCUS when an application is received from a qualified provider. The Presumptive Eligibility period continues until the Local Office approves or denies the application for medical assistance. See 477 NAC 1-012.02B and 468 NAC 1-009.01A for policy regulations.

The medical date sets for Presumptive Eligibility are used to establish temporary Medicaid eligibility and define the period of presumptive eligibility.

The example below gives the Local Office a step by step procedure to follow.

Initial Pend/Open/Close Functions

Case Approved/Denied for Medicaid

(Rev. February 7, 2000)