5220-4        REINSTATEMENT OF FAMILY OR TRANSITIONAL MEDICAID

A household who again becomes eligible for Family Medicaid during their transitional benefit period is considered dually eligible for Transitional Medicaid and Family Medicaid.  The clock on the transitional benefit period continues to run.  If the household subsequently loses FM Family Medicaid , they may be eligible for either:

1. a new transitional benefit period, if they meet the all of the conditions for Transitional Medicaid eligibility, or
    

2. the time remaining of the original Transitional Medicaid period.

Example 8:  

Mom and her three children were receiving Transitional Medicaid for seven months.  In the 7th month, Mom submits a Food Stamp review that reports she lost her job and is no longer working.  The caseworker determines the household is again Family Medicaid eligible. The worker can make a conversion to Family Medicaid if they have all the information they need.  The household is coded FM Family Medicaid -AF and given a 12 month review period (and a 12 month CEP Continuous Eligibility Period for the children).  Within two months, Mom reports and provides verification that she began a new job in which her earnings again exceed the Family Medicaid income limit.  The case is then converted back to Transitional Medicaid with three months of Transitional Medicaid eligibility remaining.  A new Transitional Medicaid period is not assigned because the household was not on Family Medicaid in three out of the last six months.  Had Mom been eligible for and received Family Medicaid for one more month, she would qualify for a new 12 month Transitional Medicaid period.

Reinstatement of Transitional Medicaid from Family Medicaid is undertaken when a worker receives a report of change or a review (or application) submitted for another program that shows the household is no longer eligible for Family Medicaid.  Reinstatement of Transitional Medicaid does not require income or resource verification.  

In order to convert from Transitional Medicaid to Family Medicaid, a report of change is sufficient as well, but the income (and resources if questionable) need to be verified.  If the client does not provide the requested verification, we leave the case in Transitional Medicaid.  

Example 9:

Mom, Dad and their two children have been on Transitional Medicaid for 4 months.  Dad calls his caseworker and reports that his income decreased significantly.  The caseworker asks about resources, requests income verification, and once received, redetermines eligibility for Family Medicaid.  If eligible, new 12 month review and continuous eligibility periods are assigned.  If the re-determination finds them ineligible for Family Medicaid, they remain on Transitional Medicaid.

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If a household lost Transitional Medicaid coverage because they moved out of state and then returned to Alaska, that household may be reinstated for the remainder of their previous Transitional Medicaid period.  The household must continue to meet all requirements of this category.  If the household returns to Alaska within a year after the FM Family Medicaid benefits were terminated, and were previously approved for Transitional Medicaid, the months of absence are counted as if the household had actually received Transitional Medicaid benefits.