10-144-332 Me. Code R. § 10-2

Current through 2024-51, December 18, 2024

Section 144-332-10-2 - MEDICALLY NEEDY ELIGIBILITY PERIOD

Section 2.1:The Prospective Period

The Medically Needy eligibility period is the time period during which the individual or family is assigned a deductible. This time period begins the first day of the month the individual first applied for Medicaid (See Part 2 Section 11), or the first day of the month after the date Medicaid ended because of excess income. The time period lasts six consecutive months.

An applicant may choose to withdraw their application for the month of submission and start the Medically Needy period for the following month, which would alter the retroactive period. (See 2.2 below.)

The six-month deductible period is shorted if:

I. The individual will turn age 21 in less than six months;

II. The individual dies;

III. The individual becomes eligible for categorical coverage; or

IV. The individual voluntarily withdraws from the program.

Section 2.2:Retroactive Periods

The applicant may request a retroactive Medically Needy period of one, two, or three months preceding the month of application if they have incurred medical expenses.

When multiple months of retroactive Medically Needy coverage are requested, coverage will not be provided for the second or third month prior to the application month without including the preceding months (first or second) unless the individual is ineligible due to basic eligibility requirements. A single retroactive deductible period is quoted to cover all requested months. See Part 2 Section 13.4 for more details.

10-144 C.M.R. ch. 332, § 10-2