PM 17-01-02: Processing the Application

WAG 17-01-02

  • revised manual textAfter receipt of the required verification, case information is compared to the program requirements to determine eligibility. Based on the type of application made, an eligibility determination is made to ensure that every person gets the most help that they are eligible to receive.
  • revised manual textIf a person requested cash and medical, an eligibility determination will be made to see if the person qualifies for any of the benefit programs including any of the Family Health Plans, SNAP benefits, QMB, SLIB, and QI-1, unless the customer expresses in writing that they do not want to apply for the benefit program. 
  • revised manual textUnless the customer declines to apply for a benefit program, eligibility is considered for all benefit programs by first determining the program that provides the most benefits. If the customer is not eligible for one program, but is eligible for another, the original application date is used to determine eligibility and the effective date for benefits.
  • revised manual textWhen completing the paper application, Request for Cash Assistance - Medical Assistance - Supplemental Nutrition Assistance Program (SNAP), or applying for benefits through the ABE Portal, the customer may indicate which benefit program they want to apply for by checking (Yes) or (No) for the specific program request on the application.
  • revised manual textIES is designed to systematically perform case progression when determining eligibility for most cash and medical benefits. The following order is used to determine the correct type of cash and medical benefits.
    • TANF or AABD Cash,
    • RRA Cash,
    • Family Assist,
    • AABD Medical without a Spenddown, Moms and Babies, FamilyCare Assist, or All Kids Assist,
    • AABD Spenddown or Family Health Spenddown Met,
    • Family Planning Program,
    • Family Health Spenddown Unmet,
    • QMB,
    • SLIB,
    • Qualified Individual-I (QI-1).

revised manual textEligibility for the Family Planning (FP) program is only assessed if the customer choses to opt-in to FP determination if found ineligible for full medical coverage. See PM 06-26-01 for more information.