Iowa Admin. Code r. 441-76.7 - Presumptive eligibility
Individuals may be temporarily enrolled in Medicaid based on a presumptive eligibility determination by a qualified entity pursuant to this rule.
(1)
For eligibility
effective prior to January 1, 2014.
a. Applicants for presumptive eligibility for
children will complete Application: Presumptive Health Care Coverage for
Children, Form 470-4855 or 470-4855(S).
b. Applicants for presumptive eligibility for
pregnant women or for presumptive eligibility for breast and cervical cancer
coverage group shall complete Health Services Application, Form 470-2927 or
Form 470-2927(S).
(2)
For eligibility effective on or after January 1, 2014.
Applicants for presumptive eligibility will complete Application for Health
Coverage and Help Paying Costs, Form 470-5170 or 470-5170(S).
(3)
How and where to file.
Applications for presumptive eligibility are filed at the office of a qualified
entity for presumptive Medicaid eligibility determinations.
(4)
Enrollment. An
individual is enrolled on the date that presumptive eligibility is determined
by the qualified entity.
(5)
Notice and appeal rights. Timely and adequate notice
requirements and appeal rights of the Medicaid program shall not apply to
presumptive eligibility decisions made by a qualified entity.
(6)
Full medical assistance
eligibility determination. All presumptive eligibility applications
shall receive a full determination of eligibility for Medicaid or HAWK-I except
for breast and cervical cancer and pregnant women coverage groups.
Notes
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