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When determining eligibility for an application, more than one month may need a determination. Determine each month up through the current calendar month separately, using the actual household situation and monthly income or monthly equivalent for each month.
A customer’s situation may change from month to month. Since eligibility is determined on a monthly basis, a customer may qualify for one month but not another.
When a customer does not qualify for MA in a past month, but qualifies in the current month, a new application is not needed.
Each month the customer qualifies for MA is approved. Any months the customer does not qualify for MA are denied.
Term |
Definition |
Denial |
A denial is a determination that a person is not eligible for Medical Assistance benefits. |
Monthly equivalent |
The MA programs that use MAGI income rules may prorate some income over more than one month: · Income received less often than monthly (see MA604D) · Regular seasonal or contract income that is not received during the entire year (see MA604F) |
Program |
Legal Authorities |
All programs except KidsCare and QMB |
42 USC 1396a(a)(34) 42 CFR 435.915 |