WAG 19-02-03-c: Review of Spenddown EDGs for Central Cancellation

PM 19-02-03-c.

If the person has not met spenddown in one of the last six months and is not enrolled in Pay-In Spenddown, on a waiting list or would be on a waiting list to receive a transplant if he or she had a source of payment, IES centrally closes the AABD Community spenddown EDG through a batch trigger at nine months following six months of unmet spenddown and sends 'Notice of Decision' (Form 360C) to the client. Form 360C contains the following message:

* You have not met your spenddown for any of the last six months. If you still need help with medical expenses, you must reapply.

Example: A customer is enrolled in AABD Community spenddown in met status for the month of December and unmet status ongoing beginning in the month of January. In July a review occurs to determine if spenddown was met in the last six months (January, February, March, April, May, June). The customer has not met spenddown in at least one of the six months reviewed. IES closes the customer's AABD Community spenddown EDG in September, effective October.