South Carolina Code of Regulations
Chapter 126 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
Article 3 - MEDICAID
Subarticle 2 - ELIGIBILITY FOR THE MEDICAL ASSISTANCE (MEDICAID) PROGRAM
Section 126-355 - Application Procedures

Universal Citation: SC Code Regs 126-355

Current through Register Vol. 48, No. 9, September 27, 2024

A. Any individual or family who is determined eligible for financial assistance under the Aid to Families with Dependent Children, Optional State Supplementation, Refugee Assistance, or Supplemental Security Income programs is eligible for Medicaid without filing a separate application.

B. If an individual who has been determined eligible for financial assistance dies before receiving an actual assistance payment, the date of application for financial assistance shall serve as the application for Medicaid. Medicaid coverage is available to the individual for the period of time for which he was determined eligible.

C. All other individuals must file an application for Medicaid benefits with the Department of Social Services.

D. The following time standards shall be used for determinations of eligibility:

(1) Sixty (60) days for applicants who apply for Medicaid on the basis of disability and forty-five (45) days for all other applicants.

(2) These time standards do not apply if unusual circumstances exist (e.g., the agency cannot reach a decision because the applicant or an examining physician delays or fails to take required action) or if there is an administrative or other emergency beyond the agency's control and a determination of eligibility cannot be made within these time standards.

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