A. Applications
submitted via any acceptable method listed in Miss. Admin. Code Part 101, Rule
4.2 should be filed with the regional office that serves the applicant's county
of residence.
1. Applications for individuals
living in another regional office's service area will be accepted by any
regional office.
2. Each regional
office must review each application upon receipt and confirm the accuracy of
the address if there is a question about the responsible
office.
B. Combination
modified adjusted gross income (MAGI) and aged, blind, disabled (ABD)
households are the responsibility of the regional office that serves the county
of residence of the household; however, if one of the ABD household members is
institutionalized, the regional office that serves the county where the
long-term care facility is located is responsible for both ABD and MAGI
cases.
C. Applications filed with
the Federally Facilitated Marketplace (FFM) are evaluated for coverage in
either Medicaid, the Children's Health Insurance Program (CHIP) or for
enrollment in a qualified health plan, i.e., insurance affordability programs.
1. If an individual or family appears to be
eligible for Medicaid or CHIP based on data verified by the FFM, the electronic
account of the individual or family is transferred to the Division of Medicaid
for completion of the application.
a) The
Account Transfer (AT) received from the FFM is evaluated for MAGI-related
coverage initially, but if any applying household member indicates that a
disability exists or if the household member is age sixty-five (65) or older,
that household member is evaluated for ABD coverage.
b) The AT record received from the FFM is the
responsibility of the regional office that serves the county of residence of
the applicant household unless one (1) member of the applying household is in
an institution.
2.
Insurance affordability programs include Medicaid, CHIP and coverage in a
qualified health plan through the FFM that provides advance payments of the
premium tax credit or cost-sharing reductions to qualified individuals.
3. MAGI-related denied
applications that are filed with the Division of Medicaid that do not indicate
ABD coverage is possible are automatically referred to the FFM for an
evaluation of coverage in a qualified health plan.
4. Non-Medicare ABD denials are referred to
the FFM for an evaluation of coverage in a qualified health plan. However, if a
MAGI-related or ABD application is denied for failure to comply with
application requirements or if the application is voluntarily withdrawn, no
referral is made to the FFM.
Miss. Code Ann. §
43-13-121.
