JCAR890120-1011664r08 1 This version includes all HFS 1st ...

JCAR890120-1011664r08688689690691692693694695696697698699700701702703704705706707708709710711712713714715716717718719720721722723724725726727728729730spenddown obligation thatwho do not have a QMB or MANG(P) member,an additional eligibility determination will be made.A) For TANF MANG, if countable income is greater than the incomestandard (Section 120.30), and for AABD MANG, if countableincome is greater than the income standard or countableresourcesassets are greater than the resourceasset disregard(Section 120.382(d)), a person will not be enrolled in spenddownunless:i) the person does not have a spenddown obligation for anymonth of the 12-month enrollment period;ii) medical expenses equal the spenddown obligation for atleast one month of the 12-month enrollment period; oriii) the person is on a waiting list or would be on a waiting listto receive a transplant if he or she had a source of payment.B) Cases that meet any of these conditions will be notified, in writing,of the spenddown obligation. The personclient will also benotified that his or her case will be reviewed beginning in the sixthmonth of the 12-month enrollment period. If the personclient hasnot had medical eligibility in one of the last three months at thetime of review (including the month of review), the case willterminate unless the case contains a person who is on a waiting listor who would be on a waiting list to receive a transplant if he orshe had a source of payment. A new application will be required ifthe personclient wishes continued medical assistance.C) When proof of incurred medical expenses equal to the spenddownobligation is provided to the local office, eligibility for medicalassistance shall begin effective the first day that the spenddownobligation is met. The Department will pay for covered servicesreceived from that date until the end of the eligibility period. Thepersonclient shall be responsible, directly to the provider, forpayment for services provided prior to the time the personclientmeets the spenddown obligation.5) Cases with a spenddown obligation that do not have a QMB, a MANG(P)member or a person on a waiting list or who would be on a waiting list toreceive a transplant if he or she had a source of payment, will be reviewedbeginning in the sixth month of enrollment to determine if they have had