New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 167 - PHARMACEUTICAL ASSISTANCE TO THE AGED AND DISABLED ELIGIBILITY MANUAL
Subchapter 5 - APPLICATION PROCESS
Section 10:167-5.3 - Eligibility effective date
Universal Citation: NJ Admin Code 10:167-5.3
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The PAAD eligibility effective date for an initial PAAD applicant, who meets all of the PAAD eligibility criteria, is the date when processing of a valid and complete eligibility application is completed by the PAAD program.
(b) The PAAD program shall conduct periodic redeterminations of the eligibility of PAAD beneficiaries.
1. Those not requested to submit a
renewal application for any given year shall be mailed an eligibility card for the year
automatically.
2. PAAD shall request and review renewal
applications to verify continued eligibility of certain beneficiaries on a case-by-case basis. Those
beneficiaries required to renew shall be notified in writing and shall receive a renewal application from
PAAD. At least 45 days prior to the expiration of PAAD benefits, the beneficiary shall submit a fully and
accurately completed renewal application form, along with the required signature(s) and supporting
documentation. However, if beneficiaries are late in submitting their renewal applications, but apply within
90 days after the expiration date, those beneficiaries who meet the PAAD eligibility criteria shall receive
continuous PAAD benefits. If the renewal application is submitted more than 90 days after the expiration
date, the eligibility effective date for eligible beneficiaries will be the date when a valid and completed
renewal application is processed by the PAAD program. If the PAAD beneficiary is late in filing his or her
renewal application by more than 90 days after the expiration date, the PAAD program shall not make
reimbursement until the new eligibility period has been established.
3. For those beneficiaries submitting renewal applications, PAAD shall
reassess eligibility. If PAAD determines that a beneficiary is eligible for the program, then PAAD shall mail
a new eligibility card to the beneficiary. If PAAD determines that a beneficiary is ineligible for the
program, then PAAD shall notify such person, in writing, and he or she shall be disenrolled from PAAD. The
PAAD program shall not reimburse a beneficiary for the cost of prescription drugs purchased after he or she
has been disenrolled from the program.
Disclaimer: These regulations may not be the most recent version. New Jersey 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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