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42 CFR 435.915 : Public Health (Part 1 To Parts 1009-1099) — (§ 430.0 To Part 481) — Centers For Medicare & Medicaid Services, Department Of Health And Human Services (Continued) (§ 430.0 To Part 481) — Medical Assistance Programs (§ 430.0 To § 456.725) — Eligibility In The States, District Of Columbia, The Northern Mariana Islands, And American Samoa (§ 435.2 To § 435.1205) — Eligibility In The States And District Of Columbia (§ 435.900 To § 435.965) — Determination Of Medicaid Eligibility (§ 435.911 To § 435.915) — Effective date.

4 Aug 2016

(a) The agency must make eligibility for Medicaid effective no later than the third month before the month of application if the individual -

(1) Received Medicaid services, at any time during that period, of a type covered under the plan; and

(2) Would have been eligible for Medicaid at the time he received the services if he had applied (or someone had applied for him), regardless of whether the individual is alive when application for Medicaid is made.

(b) The agency may make eligiblity for Medicaid effective on the first day of a month if an individual was eligible at any time during that month.

(c) The State plan must specify the date on which eligibility will be made effective.

42 CFR 435.915
[44 FR 17937, Mar. 23, 1979. Redesignated at 77 FR 17209, Mar. 23, 2012]