Utah Admin. Code R414-320-13 - Change Reporting and Benefit Changes
(1) Enrollees are required to report changes
to the eligibility agency as defined in Subsection
R414-320-3(2).
(a) The eligibility agency shall determine
the effect of the change and make the appropriate change in the enrollee's
eligibility.
(b) The eligibility
agency shall send proper notice of changes in eligibility.
(2) An enrollee who fails to report changes
or return verification timely must repay any overpayment of benefits for which
the enrollee is not eligible to receive.
(3) An eligible household may request
enrollment for an individual not enrolled in UPP; the application date for the
individual is the date of the request.
(a) A
new application form is not required.
(b) The eligibility agency determines the
individual's eligibility for UPP in accordance with Section
R414-320-11.
(c) The eligibility agency shall determine
the effective date of enrollment for individuals in accordance with Section
R414-320-12.
(d) The eligibility agency shall waive the
requirement found in Subsection
R414-320-6(2)
if the individual is a newborn or adopted child, and the request to add the
child is made within 30 days of the date of birth or adoption.
(e) A new income test must be completed for
the individual. If the individual's income places the UPP household over the
income limit for UPP, the individual is not eligible to enroll in
UPP.
(f) All other eligibility
requirements must be met.
(4) If an eligible household requests a new
eligibility determination for any household member during the certification
period, the eligibility agency shall determine if any enrolled household member
is eligible for Medicaid coverage.
(a) An
enrollee who is eligible for Medicaid coverage without a cost is no longer
eligible for UPP.
(b) An enrollee
who must meet a spenddown or MWI premium to receive Medicaid and chooses not to
meet the spenddown or MWI premium may remain on UPP.
Notes
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