7 AAC 100.072 - Retroactive Medicaid eligibility

Current through December 2, 2021

(a) At the time of application or interview, an applicant may request Medicaid coverage for a maximum of three months immediately preceding the month of application if the applicant has unpaid medical expenses for dates of service any time during that three-month period.
(b) The department will inform the applicant about potential retroactive coverage under this section as part of the application and interview process.
(c) Eligibility must be determined separately for each retroactive month in which the applicant seeks coverage. The applicant need not be eligible for Medicaid in the month of application to be found eligible in any of the retroactive months. An application for retroactive Medicaid may be filed on behalf of an individual who is deceased at the time of application.
(d) The department will use the income and resource methodology of the eligibility category for which the applicant is applying to determine the following:
(1) actual income received in the month;
(2) actual self-employment income for the month as determined under 7 AAC 100.172 and 7 AAC 100.174;
(3) actual resources that were available in that month.
(e) Postpartum Medicaid eligibility under 7 AAC 100.304 may not be granted retroactively under this section.
(f) Nothing in this section prevents the department from establishing eligibility retroactively following a disability determination, hearing under 7 AAC 49, or other department corrective action.


7 AAC 100.072
Eff. 7/20/2007, Register 183; am 1/1/2011, Register 196

Authority:AS 47.05.010

AS 47.07.020

AS 47.07.040

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