PM 18-03-08.

  1. (Customer) Completes Request for Medical Benefits for Another Family Member(s) (Form 243C) to add a person to an Assist or Moms and Babies case.
  2. (FCRC) If medical coverage is approved for noncontinuous months before the month the completed Form 243 was received, enter the first day of the month as the beginning medical eligibility date in Item 77 of Form 552.
  3. (FCRC) Send Request for Correction/Addition of MMIS Medical Eligibility File (Form 2958) to EPU to cover any other month(s) of medical eligibility in the backdated period.
  4. (FCRC) Send the client Notice of Decision to Add a Person to a Medical Assistance Case (Form 1934A) within 45 days of the application date.

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