N.J. Admin. Code § 10:167-5.3 - Eligibility effective date

(a) The PAAD eligibility effective date for an initial PAAD applicant, who meets all of the PAAD eligibility criteria, is the date when processing of a valid and complete eligibility application is completed by the PAAD program.

(b) The PAAD program shall conduct periodic redeterminations of the eligibility of PAAD beneficiaries.

1. Those not requested to submit a renewal application for any given year shall be mailed an eligibility card for the year automatically.

2. PAAD shall request and review renewal applications to verify continued eligibility of certain beneficiaries on a case-by-case basis. Those beneficiaries required to renew shall be notified in writing and shall receive a renewal application from PAAD. At least 45 days prior to the expiration of PAAD benefits, the beneficiary shall submit a fully and accurately completed renewal application form, along with the required signature(s) and supporting documentation. However, if beneficiaries are late in submitting their renewal applications, but apply within 90 days after the expiration date, those beneficiaries who meet the PAAD eligibility criteria shall receive continuous PAAD benefits. If the renewal application is submitted more than 90 days after the expiration date, the eligibility effective date for eligible beneficiaries will be the date when a valid and completed renewal application is processed by the PAAD program. If the PAAD beneficiary is late in filing his or her renewal application by more than 90 days after the expiration date, the PAAD program shall not make reimbursement until the new eligibility period has been established.

3. For those beneficiaries submitting renewal applications, PAAD shall reassess eligibility. If PAAD determines that a beneficiary is eligible for the program, then PAAD shall mail a new eligibility card to the beneficiary. If PAAD determines that a beneficiary is ineligible for the program, then PAAD shall notify such person, in writing, and he or she shall be disenrolled from PAAD. The PAAD program shall not reimburse a beneficiary for the cost of prescription drugs purchased after he or she has been disenrolled from the program.

Notes

N.J. Admin. Code § 10:167-5.3

Amended by R.1985 d.295, effective 5/20/1985.
See: 17 N.J.R. 367(a), 17 N.J.R. 1318(a).
Amended by R.1985 d.690, effective 1/21/1986.
See: 17 N.J.R. 2332(a), 18 N.J.R. 190(a).
Amended by R.1986 d.321, effective 4/4/1986.
See: 18 N.J.R. 1054(a), 18 N.J.R. 1594(b).
Amended by R.1990 d.614, effective 12/17/1990.
See: 22 N.J.R. 2218(a), 22 N.J.R. 3756(a).
Amended by R.1991 d.563, effective 11/18/1991.
See: 23 N.J.R. 2623(a), 23 N.J.R. 3514(a).
Amended by R.1993 d.155, effective 4/5/1993.
See: 24 N.J.R. 4328(a), 25 N.J.R. 1514(a).
Amended by R.1995 d.10, effective 1/3/1995.
See: 26 N.J.R. 3142(a), 27 N.J.R. 242(a).
See: 29 N.J.R. 5280(a), 30 N.J.R. 1314(b).
Amended by R.2009 d.16, effective 1/5/2009.
See: 40 N.J.R. 4479(a), 41 N.J.R. 221(a). Amended by 48 N.J.R. 1366(b), effective 7/5/2016