Potential Consumer Notices. Notice #1: In the first week of July 2011, AHCCCS will notify all Childless Adult members that on July 8, 2011 enrollment into the Childless Adult program will be frozen. If they want to retain Medicaid coverage under the Childless Adult program they will need to comply with redetermination requirements and continue to meet the eligibility requirements for that program. The first group of Childless Adult members who are SMI, aged 65 and older, under age 65 and have Medicare, and AHCCCS Care members who have HIV/AIDS and have lost coverage for AHCCCS Care because they failed to comply with the redetermination will have been already transferred to SSI MAO before this notice is generated. See Attachment #1 • Notice #2: In the month of July 2011, AHCCCS will send a notice to all AHCCCS eligible members, who are not on MED or the Childless Adult program, explaining to all remaining populations that they are not impacted by the elimination of the MED program or the freeze of the Childless Adult Program. See Attachment #2 • Notice #3 Beginning June 28 2011, and every month thereafter, AHCCCS will notify all Childless Adults who are age 65 and older, and all Childless Adults, who are under age 65 and who have Medicare, that they are being transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. Every month AHCCCS will identify Childless Adults who are age 65 or older, or under age 65 and have Medicare, and transfer them to SSI MAO. AHCCCS will notify these individuals that they are being transferred shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. This transfer will occur when the member turns 65, or when the member obtains Medicare if under age 65, and is not based on their redetermination date. AHCCCS will give these individuals the same redetermination date that they had in AHCCCS Care. See Attachment #3 • Notice #4: Beginning June 28, 2011, and every month thereafter, Childless Adults who lose coverage for the Childless Adult program, because they failed to comply with the redetermination process AND they have a diagnosis of HIV/AIDS and/or take antiretroviral drugs, will receive a notice that they are being transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. These individuals will be indentified every month and will be transferred to the SSI MAO program. They will be notified that they are being transferred to SSI MAO shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. They will have a redetermination shortly after they are transferred since they failed to comply with their Childless Adult redetermination requirements. See Attachment #4 • Notice #5: Beginning June 28, 2011, and every month thereafter, AHCCCS will notify all Childless Adults, who are identified in the AHCCCS PMMIS system as Seriously Mentally Ill (SMI) by the Arizona Department of Health Services (ADHS), that they will be transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. Every month AHCCCS will identify Childless Adults who are seriously mentally ill and transfer them to the SSI MAO program. The timing of the transfer occurs upon a member’s designation as being SMI. They will be notified that they are being transferred to SSI MAO shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. We will give these individuals the same redetermination date that they had in AHCCCS Care. See Attachment #5 • Notice #6: Childless Adults who lose coverage for the Childless Adult program (and they are not SMI, HIV/AIDS, over 65 or under 65 with Medicare), because they failed to comply with the redetermination process will receive a third and final notice from AHCCCS beginning June 25, 2011, and each month thereafter. The notice will tell them that they cannot get back into the Childless Adult program, but if they comply with redetermination requirements before the effective date of their discontinuance they can remain on AHCCCS Care. See Attachment #6 • Notice #7: Childless Adults who lose coverage for the Childless Adult program (and they are not SMI, HIV/AIDS, over 65 or under 65 with Medicare), because they failed to comply with the redetermination process will receive a discontinuance notice from the eligibility agency. The notice will tell them that they cannot get back into the Childless Adult program, they can file an appeal if they believe the discontinuance was made in error, if they appeal timely they can request continued benefits and that they can reapply for AHCCCS (but not Childless Adults). If they reapply they will need to demonstrate that they have a categorical link, including: pregnancy, parent of a deprived child, disability, or being age 65 or older. See Attachment #7 • Notice #8: Childless Adults whose redetermination is due by June 30, 2011 will receive a notice from AHCCCS in June letting them know that AHCCCS is planning to freeze Childless Adults effective July 1, 2011, pending approval from CMS. The notice will also let them know that if they do not comply with the redetermination process by June 30, 2011 they will lose AHCCCS coverage under the Childless Adult category and may not be able to get back onto AHCCCS, unless they are eligible under a categorical link such as: age 65 or older, blind, disabled, pregnant or the parent of a deprived child. This notice will also be sent in July to Childless Adults whose redetermination is due July 31, 2011, letting them know that AHCCCS will freeze enrollment for Childless Adults effective July 8, 2011, pending approval from CMS. The notice will also let them know that if they do not comply with the redetermination process by July 31, 2011, they will lose AHCCCS coverage under the Childless Adult category and may not be able to get back onto AHCCCS, unless they are eligible under a categorical link such as: age 65 or older, blind, disabled, pregnant or the parent of a deprived child. See Attachment #8 • Notice #9: Children who are aging out of the 1931, SOBRA Child, YATI (Young Adult Transitional Insurance for children 18-21 years old who aged out of xxxxxx care) and KidsCare programs will receive Notice #9 if they are aging out in the month in which their redetermination is due. The notice will advise them that if they comply with the redetermination requirements, they may be redetermined under the Childless Adults program. If they do not comply with the redetermination requirements, and their eligibility ends, they cannot apply for coverage under the Childless Adult program while enrollment is frozen. This notice will be sent June 22, 2011, and then every subsequent month. Additionally, the notice will be sent early in the month that the renewal is due. Note that Notice #9 is only triggered when an individual both ages out AND has a redetermination in the same month. This will occur each month for a small sub-set of children who are aging out of the 1931, SOBRA Child, YATI and KidsCare programs. • Notice #10: Children who aged out of the 1931, SOBRA Child, YATI and KidsCare programs will receive Notice #10 to notify them that they have been determined eligible for Childless Adults, and that they will need to comply with the redetermination process in order to remain eligible. Children who age out will be transferred to Childless Adults at the time of their birth date, and will be notified shortly after their eligibility category has changed. They will keep their same redetermination date.
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Samples: Special Terms and Conditions, Special Terms and Conditions, Special Terms and Conditions
Potential Consumer Notices. Notice #1: In the first week of July 2011, AHCCCS will notify all Childless Adult members that on July 8, 2011 enrollment into the Childless Adult program will be frozen. If they want to retain Medicaid coverage under the Childless Adult program they will need to comply with redetermination requirements and continue to meet the eligibility requirements for that program. The first group of Childless Adult members who are SMI, aged 65 and older, under age 65 and have Medicare, and AHCCCS Care members who have HIV/AIDS and have lost coverage for AHCCCS Care because they failed to comply with the redetermination will have been already transferred to SSI MAO before this notice is generated. See Attachment #1 • Notice #2: In the month of July 2011, AHCCCS will send a notice to all AHCCCS eligible members, who are not on MED or the Childless Adult program, explaining to all remaining populations that they are not impacted by the elimination of the MED program or the freeze of the Childless Adult Program. See Attachment #2 • Notice #3 Beginning June 28 2011, and every month thereafter, AHCCCS will notify all Childless Adults who are age 65 and older, and all Childless Adults, who are under age 65 and who have Medicare, that they are being transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. Every month AHCCCS will identify Childless Adults who are age 65 or older, or under age 65 and have Medicare, and transfer them to SSI MAO. AHCCCS will notify these individuals that they are being transferred shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. This transfer will occur when the member turns 65, or when the member obtains Medicare if under age 65, and is not based on their redetermination date. AHCCCS will give these individuals the same redetermination date that they had in AHCCCS Care. See Attachment #3 • Notice #4: Beginning June 28, 2011, and every month thereafter, Childless Adults who lose coverage for the Childless Adult program, because they failed to comply with the redetermination process AND they have a diagnosis of HIV/AIDS and/or take antiretroviral drugs, will receive a notice that they are being transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. These individuals will be indentified every month and will be transferred to the SSI MAO program. They will be notified that they are being transferred to SSI MAO shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. They will have a redetermination shortly after they are transferred since they failed to comply with their Childless Adult redetermination requirements. See Attachment #4 • Notice #5: Beginning June 28, 2011, and every month thereafter, AHCCCS will notify all Childless Adults, who are identified in the AHCCCS PMMIS system as Seriously Mentally Ill (SMI) by the Arizona Department of Health Services (ADHS), that they will be transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. Every month AHCCCS will identify Childless Adults who are seriously mentally ill and transfer them to the SSI MAO program. The timing of the transfer occurs upon a member’s designation as being SMI. They will be notified that they are being transferred to SSI MAO shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. We will give these individuals the same redetermination date that they had in AHCCCS Care. See Attachment #5 • Notice #6: Childless Adults who lose coverage for the Childless Adult program (and they are not SMI, HIV/AIDS, over 65 or under 65 with Medicare), because they failed to comply with the redetermination process will receive a third and final notice from AHCCCS beginning June 25, 2011, and each month thereafter. The notice will tell them that they cannot get back into the Childless Adult program, but if they comply with redetermination requirements before the effective date of their discontinuance they can remain on AHCCCS Care. See Attachment #6 • Notice #7: Childless Adults who lose coverage for the Childless Adult program (and they are not SMI, HIV/AIDS, over 65 or under 65 with Medicare), because they failed to comply with the redetermination process will receive a discontinuance notice from the eligibility agency. The notice will tell them that they cannot get back into the Childless Adult program, they can file an appeal if they believe the discontinuance was made in error, if they appeal timely they can request continued benefits and that they can reapply for AHCCCS (but not Childless Adults). If they reapply they will need to demonstrate that they have a categorical link, including: pregnancy, parent of a deprived child, disability, or being age 65 or older. See Attachment #7 • Notice #8: Childless Adults whose redetermination is due by June 30, 2011 will receive a notice from AHCCCS in June letting them know that AHCCCS is planning to freeze Childless Adults effective July 1, 2011, pending approval from CMS. The notice will also let them know that if they do not comply with the redetermination process by June 30, 2011 they will lose AHCCCS coverage under the Childless Adult category and may not be able to get back onto AHCCCS, unless they are eligible under a categorical link such as: age 65 or older, blind, disabled, pregnant or the parent of a deprived child. This notice will also be sent in July to Childless Adults whose redetermination is due July 31, 2011, letting them know that AHCCCS will freeze enrollment for Childless Adults effective July 8, 2011, pending approval from CMS. The notice will also let them know that if they do not comply with the redetermination process by July 31, 2011, they will lose AHCCCS coverage under the Childless Adult category and may not be able to get back onto AHCCCS, unless they are eligible under a categorical link such as: age 65 or older, blind, disabled, pregnant or the parent of a deprived child. See Attachment #8 • Notice #9: Children who are aging out of the 1931, SOBRA Child, YATI (Young Adult Transitional Insurance for children 18-21 years old who aged out of xxxxxx care) and KidsCare programs will receive Notice #9 if they are aging out in the month in which their redetermination is due. The notice will advise them that if they comply with the redetermination requirements, they may be redetermined under the Childless Adults program. If they do not comply with the redetermination requirements, and their eligibility ends, they cannot apply for coverage under the Childless Adult program while enrollment is frozen. This notice will be sent June 22, 2011, and then every subsequent month. Additionally, the notice will be sent early in the month that the renewal is due. Note that Notice #9 is only triggered when an individual both ages out AND has a redetermination in the same month. This will occur each month for a small sub-set of children who are aging out of the 1931, SOBRA Child, YATI and KidsCare programs. • Notice #10: Children who aged out of the 1931, SOBRA Child, YATI and KidsCare programs will receive Notice #10 to notify them that they have been determined eligible for Childless Adults, and that they will need to comply with the redetermination process in order to remain eligible. Children who age out will be transferred to Childless Adults at the time of their birth date, and will be notified shortly after their eligibility category has changed. They will keep their same redetermination date.
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Samples: Special Terms and Conditions, Special Terms and Conditions
Potential Consumer Notices. Notice #1: In the first week of July 2011, AHCCCS will notify all Childless Adult members that on July 8, 2011 enrollment into the Childless Adult program will be frozen. If they want to retain Medicaid coverage under the Childless Adult program they will need to comply with redetermination requirements and continue to meet the eligibility requirements for that program. The first group of Childless Adult members who are SMI, aged 65 and older, under age 65 and have Medicare, and AHCCCS Care members who have HIV/AIDS and have lost coverage for AHCCCS Care because they failed to comply with the redetermination will have been already transferred to SSI MAO before this notice is generated. See Attachment #1 • Notice #2: In the month of July 2011, AHCCCS will send a notice to all AHCCCS eligible members, who are not on MED or the Childless Adult program, explaining to all remaining populations that they are not impacted by the elimination of the MED program or the freeze of the Childless Adult Program. See Attachment #2 • Notice #3 Beginning June 28 2011, and every month thereafter, AHCCCS will notify all Childless Adults who are age 65 and older, and all Childless Adults, who are under age 65 and who have Medicare, that they are being transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. Every month AHCCCS will identify Childless Adults who are age 65 or older, or under age 65 and have Medicare, and transfer them to SSI MAO. AHCCCS will notify these individuals that they are being transferred shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. This transfer will occur when the member turns 65, or when the member obtains Medicare if under age 65, and is not based on their redetermination date. AHCCCS will give these individuals the same redetermination date that they had in AHCCCS Care. See Attachment #3 • Notice #4: Beginning June 28, 2011, and every month thereafter, Childless Adults who lose coverage for the Childless Adult program, because they failed to comply with the redetermination process AND they have a diagnosis of HIV/AIDS and/or take antiretroviral drugs, will receive a notice that they are being transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. These individuals will be indentified every month and will be transferred to the SSI MAO program. They will be notified that they are being transferred to SSI MAO shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. They will have a redetermination shortly after they are transferred since they failed to comply with their Childless Adult redetermination requirements. See Attachment #4 • Notice #5: Beginning June 28, 2011, and every month thereafter, AHCCCS will notify all Childless Adults, who are identified in the AHCCCS PMMIS system as Seriously Mentally Ill (SMI) by the Arizona Department of Health Services (ADHS), that they will be transferred to the SSI MAO program. The SSI MAO program will not be frozen and SSI MAO staff will contact these individuals for a redetermination of their eligibility under SSI MAO rules. Every month AHCCCS will identify Childless Adults who are seriously mentally ill and transfer them to the SSI MAO program. The timing of the transfer occurs upon a member’s designation as being SMI. They will be notified that they are being transferred to SSI MAO shortly after their eligibility category has changed from AHCCCS Care to SSI MAO. We will give these individuals the same redetermination date that they had in AHCCCS Care. See Attachment #5 • Notice #6: Childless Adults who lose coverage for the Childless Adult program (and they are not SMI, HIV/AIDS, over 65 or under 65 with Medicare), because they failed to comply with the redetermination process will receive a third and final notice from AHCCCS beginning June 25, 2011, and each month thereafter. The notice will tell them that they cannot get back into the Childless Adult program, but if they comply with redetermination requirements before the effective date of their discontinuance they can remain on AHCCCS Care. See Attachment #6 • Notice #7: Childless Adults who lose coverage for the Childless Adult program (and they are not SMI, HIV/AIDS, over 65 or under 65 with Medicare), because they failed to comply with the redetermination process will receive a discontinuance notice from the eligibility agency. The notice will tell them that they cannot get back into the Childless Adult program, they can file an appeal if they believe the discontinuance was made in error, if they appeal timely they can request continued benefits and that they can reapply for AHCCCS (but not Childless Adults). If they reapply they will need to demonstrate that they have a categorical link, including: pregnancy, parent of a deprived child, disability, or being age 65 or older. See Attachment #7 • Notice #8: Childless Adults whose redetermination is due by June 30, 2011 will receive a notice from AHCCCS in June letting them know that AHCCCS is planning to freeze Childless Adults effective July 1, 2011, pending approval from CMS. The notice will also let them know that if they do not comply with the redetermination process by June 30, 2011 they will lose AHCCCS coverage under the Childless Adult category and may not be able to get back onto AHCCCS, unless they are eligible under a categorical link such as: age 65 or older, blind, disabled, pregnant or the parent of a deprived child. This notice will also be sent in July to Childless Adults whose redetermination is due July 31, 2011, letting them know that AHCCCS will freeze enrollment for Childless Adults effective July 8, 2011, pending approval from CMS. The notice will also let them know that if they do not comply with the redetermination process by July 31, 2011, they will lose AHCCCS coverage under the Childless Adult category and may not be able to get back onto AHCCCS, unless they are eligible under a categorical link such as: age 65 or older, blind, disabled, pregnant or the parent of a deprived child. See Attachment #8 • Notice #9: Children who are aging out of the 1931, SOBRA Child, YATI (Young Adult Transitional Insurance for children 18-21 years old who aged out of xxxxxx care) and KidsCare programs will receive Notice #9 if they are aging out in the month in which their redetermination is due. The notice will advise them that if they comply with the redetermination requirements, they may be redetermined under the Childless Adults program. If they do not comply with the redetermination requirements, and their eligibility ends, they cannot apply for coverage under the Childless Adult program while enrollment is frozen. This notice will be sent June 22, 2011, and then every subsequent month. Additionally, the notice will be sent early in the month that the renewal is due. Note that Notice #9 is only triggered when an individual both ages out AND has a redetermination in the same month. This will occur each month for a small sub-set of children who are aging out of the 1931, SOBRA Child, YATI and KidsCare programs. • Notice #10: Children who aged out of the 1931, SOBRA Child, YATI and KidsCare programs will receive Notice #10 to notify them that they have been determined eligible for Childless Adults, and that they will need to comply with the redetermination process in order to remain eligible. Children who age out will be transferred to Childless Adults at the time of their birth date, and will be notified shortly after their eligibility category has changed. They will keep their same redetermination date.
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Samples: Special Terms and Conditions, Special Terms and Conditions
