Family Healthcare (FAMIS)

0910.050.20.10 RESPONSE FROM CLIENT

IM-54 June 2, 2005IM-46 March 2, 2001

If eligibility is not established in the ex-parte review but the individual responds to the Pre-Closing Review Notice indicating other possible eligibility, register the appropriate application in IAPP.

Allow the current TMA eligibility for the individual to remain open pending the eligibility determination for the other category. Update the IMU5 with case action 29, re-enter reason for closing and entering a new day in Field 32 of three (3) months in the future to do this. This action will prevent the system from converting to MC+ for Children at the end of the original time limit.

If the client notifies the worker of a change in circumstances, such as a change in income, re-evaluate eligibility for MAF.

No new, signed application from the individual is required to switch categories. Use the IM-2D when determining eligibility under Medical Assistance. One category of coverage should not be stopped before the other category is approved or determined ineligible.

NOTE: If the individual does not respond to the Pre-Closing Review Notice within ten (10) days, but does respond indicating other possible eligibility prior to the termination of the TMA, follow the same instructions above. If they respond indicating other possible eligibility after the case is closed, treat as a new application.