PM 18-05-08.

(FCRC) The only time a Family Community Resource Center can delete code X from Item 25 is when SWAPping a case to TANF.

(MEU) The MEU terminates extended medical by deleting code X from Item 25 if a family fails to return Form 3361. If food stamp information is available in ACID, the MEU attempts to determine eligibility for all other medical programs.

  • If eligibility can be determined for a medical program other than extended medical, the MEU makes any necessary changes to Items 78, 80, and 90. The case then becomes an Assist case and becomes the responsibility of the Family Community Resource Center.
  • If eligibility cannot be determined, the MEU deletes each person from the medical case who is not pregnant or under age 19. Pregnant women are automatically eligible through 60-days postpartum and children under 19 have Continuous Medicaid Eligibility for 12 months from the LMDD. For cases with food stamps, the deleted person(s) remains in the case to receive only FS. The case becomes an Assist or Moms and Babies case.

Example 1: Extended medical for Ms. E and her 3 children began 03/02. Form 3361 due for the 4th month of the extended medical period is not returned. Since she receives food stamps, the MEU reviews her food stamp information on ACID. ACID shows that current gross income is $1,200, which is above the FamilyCare Assist Standard but below the All Kids Assist Standard.

The MEU terminates extended medical effective 09/02 by deleting code X from Item 25, deletes the parents, and puts the children in All Kids Assist. Item 30 is updated since the MEU completed a REDE. The case becomes the responsibility of the Family Community Resource Center.

Example 2: Extended medical for Mr. and Mrs. F and their 3 children began 04/02. Form 3361 due for the 4th month of the extended medical period is not returned. No one receives food stamp benefits.

The MEU terminates extended medical effective 10/01 by deleting code X from Item 25, and deletes Mr. and Mrs. F from the case. The children remain on the case because they have Continuous Medicaid Eligibility. The case becomes the responsibility of the Family Community Resource Center.

Example 3: Extended medical for Ms. G and her 3 children began 05/02. Form 3361 due for the 4th month of the extended medical period is not returned. No one receives food stamp benefits. An EDD for Ms. G appears in Item 60.

The MEU terminates extended medical effective 11/02 by deleting code X from Item 25. All persons remain active for medical, the mother because she is pregnant and the children because they are under age 19. Item 30 is not updated because MEU was unable to complete a REDE. The case becomes the responsibility of the Family Community Resource Center.

(FCRC) When extended medical is terminated and a case becomes an Assist or Moms and Babies case, it is the responsibility of the Family Community Resource Center. The Family Community Resource Center must REDE the case 12 months from the LMDD. This is the month after the 12-month extended medical would have ended if income had not been above the standard.

Example 1: The family's extended medical began 01/02. The MEU terminates extended medical effective 07/02 because Form 3361 returned for the 4th month reported income is above the extended medical standard. Following this action, the case is an Assist case and is the responsibility of the Family Community Resource Center because the children must receive medical benefits through January 2003. The case will appear due for a REDE on the PAL for January 2003.

Example 2: The family's extended medical began 03/02. The MEU terminates extended medical effective 09/02 because Form 3361 due for the 4th of the extended medical period is not returned. Following this action, the case becomes the responsibility of the Family Community Resource Center and the next REDE is due 08/03 (12 months from the determination of eligibility by the MEU).

(MEU) Cancels the case when the:

  • family requests cancellation (TAR 91);
  • family no longer resides in Illinois (TAR 78);
  • only eligible child is no longer in the home or reaches age 19 (TAR 76); or
  • a person receiving extended medical in an adult-only case fails to return Form 3361 (TAR 89).