Member Eligibility Redetermination. In an effort to minimize the number of Disenrollments due to loss of Medicaid eligibility, the Department will provide the CONTRACTOR with a monthly listing of Medicaid Managed Care Members who were mailed an eligibility Redetermination/Review Form during the month. The term Redetermination shall be used interchangeably with renewal of eligibility. For specific Disenrollment provisions, please refer to the Member Disenrollment Section below and the Medicaid Managed Care Policy and Procedure Guide. The CONTRACTOR may:
Member Eligibility Redetermination. In an effort to minimize the number of Disenrollments due to loss of Medicaid eligibility, the Department will provide the CONTRACTOR with a monthly listing of Medicaid Managed Care Members who were mailed an eligibility Redetermination/Review Form during the month. The term Redetermination shall be used interchangeably with renewal of eligibility. For specific Disenrollment provisions, please refer to the Member Disenrollment Section below and the Medicaid Managed Care Policy and Procedure Guide. The CONTRACTOR may: Use the Redetermination notice information to inform the Medicaid Managed Care Member of the need to reapply for Medicaid eligibility. Also use this information to assist its Medicaid Managed Care Members in taking appropriate action to maintain Medicaid eligibility.
