New questions have been added in the Maryland Health Connection application to allow consumers to report incarceration status, and incarceration-specific language has been added to the attestation screen.
Consumers who become incarcerated are no longer eligible for QHP coverage or a Medicaid MCO. Release from incarceration is a qualifying life event that opens an SEP.
Change reporting for QHP consumers:
- QHP primary applicant becomes incarcerated. Using the new change-reporting option Change Incarceration Status, if a change is reported to indicate the primary is currently incarcerated, with no pending disposition, the system shall disenroll the entire household, following the 15th of the month rule. QHP dependents may reapply using the “loss of coverage” SEP.
- QHP dependent becomes incarcerated. Using the new change report option Change Incarceration Status, if a change is reported to indicate a QHP dependent is currently incarcerated, with no pending disposition, the system shall disenroll only the QHP dependent, following the 15th of the month rule. Financial assistance may change for the remaining household members.
- Individual is released from incarceration.
- A currently incarcerated individual who will be released in the next 60 days will be considered for QHP and Medicaid MCO eligibility. If determined eligible for QHP, his/her coverage will begin on the 1st of the month after he/she is released
- An incarcerated individual who was released in the last 60 days will be considered for QHP eligibility and Medicaid MCO. If determined eligible for a QHP, his/her coverage will begin on the 1st of the month after enrollment.
All incarcerated consumers will be considered for Medicaid FFS eligibility.
Consumers who are incarcerated will not be eligible to enroll or remain in a Medicaid MCO but will be eligible for fee-for-service (FFS) Medicaid, assuming all other Medicaid eligibility requirements are met. Medicaid enrollees who report a change in incarceration status will be moved in or out of MCO enrollment by DHMH using a report generated by HBX.
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