PM 06-26-05-a Case Changes

WAG 06-26-05-a

Individuals become ineligible for the Family Planning program in the following circumstances:

  • Individual moves out of state
  • Individual's income exceeds Family Planning limit
  • Individual enrolls in full state or federal non-spenddown medical coverage

Cases determined ineligible for Family Planning coverage will close the next effective month.

Note: If individual has an active Family Planning case and later reports a pregnancy which is added to the case in IES, Family Planning coverage should not close. When redetermination is performed, the FP coverage will be systematically closed by IES. Active pregnancy will only disqualify an individual requesting FPPE, initial FP coverage and at redetermination of FP.

TIP: If individual wants to be determined for full coverage to receive pregnancy benefits, the individual must submit an application requesting full medical coverage.

Becoming Eligible for Full Medical Coverage

If a customer reports changes that would make them eligible for full medical coverage and they would like to be determined for full medical coverage, they must submit a new application for determination. If the customer is found eligible and approved for full medical benefits, Family Planning will end the next effective month.