130 CMR, § 520.031 - Notification of Potential Eligibility
(A) The MassHealth agency informs the
applicant who has excess monthly income that he or she is currently ineligible
for MassHealth Standard, Family Assistance or Limited but may establish
eligibility for a six-month period by meeting the deductible. The MassHealth
agency informs the applicant in writing of the following:
(1) the deductible amount and the method of
calculation;
(2) the start and end
dates of the deductible period;
(3)
the procedures for submitting medical bills;
(4) his or her responsibility to report all
changes in circumstances that may affect eligibility or the deductible amount;
and
(5) that the bills submitted to
meet the deductible are the responsibility of the individual and cannot be
submitted for MassHealth agency payment.
(B) A member who has established eligibility
based upon meeting a deductible is only eligible for MassHealth Standard,
Family Assistance, or Limited until the end of the deductible period. At the
end of the deductible period, the MassHealth agency notifies the member in
writing of a new deductible period and amount, if the countable-income amount
continues to exceed applicable income standards.
Notes
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