1. (a) A new application must be made if, at the time of application, the individual is not receiving Medicaid under this chapter and is not a member of a household receiving Medicaid under this chapter.

2. (b) The department may determine eligibility without requiring the applicant or recipient to submit a new application under the following circumstances if the department already has enough information to determine eligibility:

   1. (1) a recipient is moving from one eligibility category to another eligibility category;
   2. (2) an individual is being added to an ongoing Medicaid case and the caseworker is able to obtain all other needed verification and documentation;
   3. (3) an individual is already receiving benefits administered by the division handling public assistance within the department, and the existing public assistance record contains enough information to determine Medicaid eligibility;
   4. (4) a household moves from Family Medicaid to Transitional Medicaid or from Transitional Medicaid to Family Medicaid;
   5. (5) a child who has been eligible under a category in 7 AAC 100.002(a) or (c) related to Family Medicaid moves to the disability-related eligibility category in 7 AAC 100.002(d)(5);
   6. (6) an individual submits a Medicaid application form designed for a different Medicaid eligibility category than the one intended, but the application form submitted contains enough information for the department to determine eligibility for the intended category;
   7. (7) the department is reinstating benefits for a recipient whose Medicaid eligibility was terminated, if the recipient has made a timely request for a hearing under 7 AAC 49, or reinstatement of eligibility is ordered under 7 AAC 49 or by the court.

(Eff. 7/20/2007, Register 183; am 4/4/2013, Register 206)

Authority: AS 47.05.010, AS 47.07.040