Regular to Spenddown
- (FCRC) When a case changes from Regular to Spenddown, complete and send Form 2434A (with Form 458SPA/SPB attached, if needed) or Form 2434C in a timely manner. Form 2434A or Form 2434C tells the client that they will no longer
receive a MediPlan Card and that they are enrolled for spenddown because of excess monthly income and/or assets.
- (FCRC) Revise and submit Form 552 with TA 31/TAR 57 to enroll the client for spenddown for the first month for which medical benefits can be stopped (see WAG
- (FCRC) Enter code 390 SPD or 391 SPDGC in Item 80.
- (FCRC) For AABD Medical, enter code 392 AST in Item 80.
- (FCRC) Show spenddown status as unmet.
Example: The Family Community Resource Center determines that due to a change in income a regular AABD Medical case should be enrolled in spenddown. On 01/31 the Family Community Resource Center takes action to process the change on Form 552. The client has already received
the February MediPlan Card on 01/29. To stop medical benefits for March, enter 03/99 for effective date in Item 2, and code 2 (spenddown) in Item 80.
- (FCRC) Establish a spenddown record in ASDS.
Spenddown to Regular
Take the following action for a spenddown case, whether in met or unmet status, when a case changes from Spenddown to Regular.
- (FCRC) Complete and send Form 2434A (with Form 458SPA/SPB attached, if needed) or Form 2434C to notify the client of the change and the date that medical eligibility begins.
- (FCRC) Revise and submit Form 552 with TA 31/TAR 57 if sufficient time remains in the approval period (see WAG 18-05-02).
- (FCRC) Delete the spenddown code, indicator, and amount in Item 80.
- (FCRC) If the case was in met status (code 1 or 3), make no entry in Item 77.
Enter the month, day, and year that eligibility for Regular began, in Item 77 if the case is in unmet status.
- (FCRC) For AABD Medical cases, delete code 392 AST in Item 80.
- (FCRC) If the Spenddown case is centrally ended before it can be changed to Regular, complete and submit a Form 552 for the month for which the Spenddown case has been ended, approving a Regular case (see WAG 15-08-10).
Do not ask the client to complete an application form to establish the Regular case.