Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 101 - Coverage Groups and Processing Applications and Reviews Redetermination Processes
Chapter 8 - Eligibility Dates
Rule 23-101-8.4 - Retroactive Medicaid Eligibility
Universal Citation: MS Code of Rules 23-101-8.4
Current through September 24, 2024
A. Retroactive Medicaid eligibility may be available to any Medicaid applicant who received medical care prior to applying for Medicaid.
B. Retroactive eligibility may include all three (3) or any of the three (3) months prior to the month of application. In addition:
1. Each Applicant is informed of
the availability of retroactive Medicaid coverage.
2. The applicant's statement is accepted
regarding medical expenses incurred in the retroactive period.
3. Retroactive Medicaid may also be available
to an individual who is added to a case such as a child who returns home.
4. The applicant does not have to
be eligible in the month of the application or even the current month to be
eligible for one (1) or more months of retroactive Medicaid.
5. The applicant or beneficiary may ask for
retroactive Medicaid coverage at any time.
6. The date of application, rather than the
date of the eligibility determination, establishes the beginning of the three
(3) month retroactive period.
7.
There is no provision for retroactive coverage in the Qualified Medicare
Beneficiary (QMB) program. QMB eligibility begins the month following the month
of authorization. QMBs cannot be placed into a Specified Low-Income Medicare
Beneficiary (SLMB) or Qualified Individual (QI)-1 category of eligibility to
provide retroactive payment of Medicare Part B premiums for the retro period.
8. Hospital Presumptive
Eligibility (HPE) has no retroactive coverage.
a) If a full application for Medicaid is
filed and approved, retroactive Medicaid is available for up to three (3)
months prior to the month the full Medicaid application is filed.
b) Any partial month of eligibility granted
under HPE is changed to a full month of eligibility, provided the full
application is timely filed.
42 C.F.R. §§ 435. 915435.1110.
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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