1. (1) The earliest date of entitlement for Medicaid is the first day of the month of application for assistance under one of the categorical programs, provided the individual meets all factors of eligibility for that month. The individual who is eligible on the first day of the month is entitled to Medicaid for the full month.
2. (2) An exception to (1), above, is Retroactive Medicaid Coverage. Individuals who have incurred medical expenses for the three months immediately preceding the month of application for Medicaid or the three months prior to the receipt of the first SSI check (for SSI cases), may become eligible for Medicaid benefits during that time provided all eligibility requirements are met for each month.

Author: Denise Banks, Associate Director, Policy and Training, Beneficiary Services Division

Statutory Authority: Social Security Act, Titles IV-A, XVI, XIX; 42 C.F.R. §435.914; State Plan.

History: Rule effective October 1, 1982. Amended: effective March 11, 1986; January 14, 1987; September 13, 1990. Amended: Filed October 7, 1993; effective November 12, 1993. Amended: Filed December 8, 1997; effective January 12, 1998. Amended: Filed February 11, 2014; effective March 18, 2014. Amended: Filed September 11, 2018; effective October 26, 2018.