Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.41 - Employed Individuals with Disabilities
Section 10.09.41.05 - Application Requirements - Determination and Redetermination of Eligibility
Universal Citation: MD Code Reg 10.09.41.05
Current through Register Vol. 51, No. 19, September 20, 2024
A. Application.
(1) To any individual requesting information,
the Department shall provide oral or written information about:
(a) EID eligibility requirements;
(b) The coverage, scope, and related services
of the Medical Assistance Program; and
(c) Applicants' and recipients' rights and
obligations under the Medical Assistance Program.
(2) The Department shall issue an EID
application form to any individual upon request.
(3) An applicant or recipient may apply for a
determination or a redetermination of eligibility for the EID coverage group by
submitting to the Department:
(a) The
application form designated by the Department and signed in accordance with the
signature requirements of COMAR 10.09.24;
(b) The social security numbers of each
member of the assistance unit, in accordance with §A(5) of this
regulation; and
(c) Signed consent
forms as specified in §A(4) of this regulation.
(4) Consent Forms. An applicant or recipient,
or, if necessary and consistent with the signature requirements specified in
COMAR 10.09.24, a representative or other individual acting on behalf of the
applicant or recipient, shall sign consent forms as needed to authorize the
Department's verification of information needed to establish eligibility
through sources such as employers, banks, and public or private
agencies.
(5) Social Security
Number.
(a) As required in COMAR 10.09.24 for
each assistance unit member requesting benefits under this chapter, an
applicant or recipient shall:
(i) Provide the
Department with the individual's Social Security number; or
(ii) Verify that the individual has applied
to the Social Security Administration for a Social Security card.
(b) An applicant's or recipient's
failure to meet the requirements of §A(5)(a) of this regulation shall
result in a determination of ineligibility under this chapter.
(6) An applicant or recipient
shall provide to the Department information and verifications needed for the
determination of all elements of nonfinancial, income, and resource
eligibility, including but not limited to information relating to health
insurance coverage or potential third-party payments.
(7) Additional Information Requirements. An
applicant or recipient shall, at the Department's request:
(a) Be available for and participate in an
interview; and
(b) Answer questions
and provide information relevant to:
(i) The
applicant's eligibility for the EID coverage group; or
(ii) The recipient's continuing eligibility
for the EID coverage group.
(8) An individual temporarily absent from the
State who intends to return to the State:
(a)
May apply to the Department by mail for the EID coverage group; and
(b) To establish eligibility for the EID
coverage group, shall:
(i) Demonstrate
continued residency in the State; and
(ii) Meet all technical and financial
requirements of eligibility under this chapter.
(9) An applicant or recipient shall cooperate
and assist with the Department's eligibility determination or redetermination
process under this chapter, including but not limited to the requirements of
§A of this regulation.
B. The Department shall:
(1) Maintain a case record for the applicant
or recipient, including documentation of all required elements of
eligibility;
(2) Conduct a
wage-screening inquiry to determine wages, benefits, and claimant history for
each assistance unit member;
(3)
Verify all factors of eligibility under this chapter for each assistance unit
member applying for the EID coverage group; and
(4) Restrict disclosures of information
concerning applicants and recipients to purposes directly connected with the
administration of the EID coverage group of the Medical Assistance
program.
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