461-135-0875    Effective 07/01/08
Specific Requirements; Retroactive Medical

  1. The following clients are evaluated for retroactive eligibility for medical assistance:

    1. Clients applying for the BCCM, MAA, MAF, OSIPM, QMB-DW, REFM, or SAC program. This includes deceased individuals who would have been eligible for Medicaid covered services had they, or someone acting on their behalf, applied.

    2. Clients found ineligible for the BCCM, MAA, MAF, OSIPM, or SAC program solely because they do not meet the citizenship requirements of OAR 461-120-0125. Clients eligible under this subsection are eligible only for CAWEM program benefits (see OAR 461-135-1070).

    3. Clients found eligible for QMB-BAS, who are evaluated for OSIPM retroactive eligibility.

  2. If eligible for medical assistance retroactively, the client's eligibility cannot start earlier than the date indicated by OAR 461-180-0140.

  3. In the BCCM program, a woman cannot be eligible prior to January 1, 2002.

  4. In the OHP and QMB-BAS programs, there are no retroactive medical benefits.

Stat. Auth.: ORS 411.060
Stats. Implemented: ORS 411.060

Previous Rules