Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 477 - MEDICAID ELIGIBILITY
Chapter 3 - APPLICATION PROCESS
Section 477-3-007 - RENEWALS

Universal Citation: 477 NE Admin Rules and Regs ch 3 ยง 007

Current through March 20, 2024

A redetermination of eligibility for continued Medicaid benefits must be completed every 12 months.

007.01 RENEWAL OF ELIGIBILITY FOR MODIFIED ADJUSTED GROSS INCOME (MAGI) PROGRAMS. A renewal of modified adjusted gross income (MAGI)-based eligibility shall be completed on the basis of information available to the Department without requiring information from the individual. Information will only be required from the individual when not available through other sources. If information is not available to complete a renewal, a prepopulated renewal form shall be sent by the Department to the applicant or authorized representative. The completed renewal form and necessary verifications shall be returned within 30 days of the date the renewal form was sent. .

007.02 RENEWAL OF ELIGIBILITY FOR NON-MODIFIED ADJUSTED GROSS INCOME (non-MAGI) PROGRAMS. A prepopulated renewal form shall be required every 12months for non-modified adjusted gross income (non-MAGI) based eligibility renewals.

007.03 RENEWAL FOR SUPPLEMENTAL SECURITY INCOME (SSI) RECIPIENTS. A renewal form is not required at the time of renewal for clients who are receiving supplemental security income (SSI).

007.03(A) RENEWAL WHEN SUPPLEMENTAL SECURITY INCOME (SSI) IS DISCONTINUED. If supplemental security income (SSI) is discontinued and:
(i) The last application was completed more than 12 months from the last month of eligibility for supplemental security income (SSI), a determination of eligibility must be completed within the next 30 days, including completion of an application; or

(ii) It has been less than 12 months since completion of the last application, a review of all eligibility requirements necessary for continued assistance must be completed.

007.03(B) RENEWAL DURING NON-PAY SUPPLEMENTAL SECURITY INCOME (SSI) STATUS. A renewal is not required for periodic non-pay status due to an extra pay period in a month.

007.03(C) SUPPLEMENTAL SECURITY INCOME (SSI) CLIENTS ELIGIBLE UNDER 1619(b). Supplemental security income (SSI) clients who are determined eligible for Medicaid by the Social Security Administration (SSA) under the provisions of 1619(b) are not required to complete a renewal form, and resources do not need to be verified.

007.04 INCOME REVIEW FOR AGED, BLIND, AND DISABLED (ABD) CLIENTS. For eligibility purposes, a review of income must be completed every 12 months. An income review is completed by the Social Security Administration (SSA) for supplemental security income (SSI) clients, including those placed in 1619(b) status.

007.05 DISABILITY REVIEW FOR AGED, BLIND, AND DISABLED (ABD) CLIENTS. For clients whose disability status is approved by the State Review Team (SRT), a review of disability for aged, blind, and disabled (ABD) eligibility must be completed by the State Review Team at least every 12 months.

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