Utah Admin. Code R414-311-5 - Application, Eligibility Reviews and Improper Medical Assistance

(1) Unless otherwise stated, the provisions of Rule R414-308 apply to all applicants and enrollees.
(2) Subject to the provisions of Subsection R414-311-5(3), an individual who is determined eligible shall receive 12 months of coverage that begins with the first month of enrollment.
(3) Before the end of the 12-month certification period, the eligibility agency may terminate eligibility if the individual:
(a) turns 65 years old;
(b) moves out of state;
(c) becomes eligible for another Medicaid program;
(d) enters an institution for mental disease, except as described in Section R414-302-6;
(e) is convicted of fraud;
(f) leaves the household; or
(g) is eligible for or receives Medicare.
(4) An individual who leaves prison, jail, or the Utah State Hospital must submit an application within 60 days of release or discharge.
(5) An enrollee must verify at each review, that the enrollee meets the criteria of a coverage group, as defined in Section R414-311-2. An enrollee who no longer meets criteria of a coverage group is no longer eligible for Targeted Adult Medicaid.

Notes

Utah Admin. Code R414-311-5
Adopted by Utah State Bulletin Number 2018-11, effective 5/8/2018 Amended by Utah State Bulletin Number 2020-08, effective 3/27/2020

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