Common use of Redetermination of Eligibility Clause in Contracts

Redetermination of Eligibility. Redetermination of eligibility for HIP will occur at least once every 12 months. An enrollee may request a redetermination of eligibility for HIP due to a change in family size (e.g., death, divorce, birth, marriage, adoption) at any time, and the state must perform such redeterminations upon request. Requests for redetermination based on changes in income will be subject to a once a year qualifying event. A “qualifying event” is defined as a job loss or other event resulting in a change in income. Each redetermination must include a reassessment of the individual’s eligibility for Medicaid, and may result in a reduction of the enrollee’s required POWER Account contribution. The state may consider allowing more than one “qualifying event” a year on a case-by-case basis, if the HIP member experiences a job loss or other change in income that results in undue hardship. The enrollee’s MCO may assist the enrollee in completing the steps necessary to remain eligible for HIP.

Redetermination of Eligibility. Redetermination of eligibility for HIP will occur at least once every 12 months. An enrollee may request a redetermination of eligibility for HIP due to a change in family size (e.g., death, divorce, birth, marriage, adoption) at any time, and the state State must perform such redeterminations upon request. Requests for redetermination based on changes in income will be subject to a once a year qualifying event. A “qualifying event” ―qualifying event‖ is defined as a job loss or other event resulting in a change in income. Each redetermination must include a reassessment of the individual’s eligibility for Medicaid, and may result in a reduction of the enrollee’s required POWER Account contribution. The state State may consider allowing more than one “qualifying event” ―qualifying event‖ a year on a case-by-case basis, if the HIP member experiences a job loss or other change in income that results in undue hardship. The enrollee’s MCO may assist the enrollee in completing the steps necessary to remain eligible for HIP.

Redetermination of Eligibility. Redetermination of eligibility for HIP will occur at least once every 12 months. An enrollee may request a redetermination of eligibility for HIP due to a change in family size (e.g., death, divorce, birth, marriage, adoption) at any time, and the state State must perform such redeterminations upon request. Requests for redetermination based on changes in income will be subject to a once a year qualifying event. A “qualifying event” is defined as a job loss or other event resulting in a change in income. Each redetermination must include a reassessment of the individual’s eligibility for Medicaid, and may result in a reduction of the enrollee’s required POWER Account contribution. The state State may consider allowing more than one “qualifying event” a year on a case-by-case basis, if the HIP member experiences a job loss or other change in income that results in undue hardship. The enrollee’s MCO may assist the enrollee in completing the steps necessary to remain eligible for HIP.