HAR §17-1720.1-21. Effective date of enrollment

(a) The effective date of enrollment for a newly eligible individual shall be one of the following: (1) The date a completed application is received by the department; (2) Any date specified by the applicant on which appropriate Medicaid eligible services were UNOFFICIAL 1720.1-11 incurred in accordance with chapter 17- 1730.1 and is no earlier than the first (1st) day of the third (3rd) month prior to the month the application is received by the department for individuals applying for the coverage of long-term care services or the tenth (10th) calendar day immediately prior to the date the application is received by the department for all other individuals; (3) The start date of the participating health plan contract period in which an eligibility determination is made for retroactive coverage; or (4) The date when all eligibility requirements were met. (b) For an individual with cause as defined in section 17-1720.1-18 who changes health plans, the effective date of enrollment in the new health plan shall be the first (1st) day of the month as designated by the department. (c) For an eligible individual disenrolled from a health plan due to temporary loss of eligibility for a period of six (6) months or less and as a result missed the annual plan change period, the effective date of enrollment shall be the same date as subsection (a)(4). (d) For an enrolled individual who relocates to a service area where the health plan does not provide service, the effective date of enrollment shall be the date of the individual’s relocation. (e) For a newborn born to an eligible individual, the effective date of enrollment shall be the date of birth. (f) For an individual changing from one health plan to another during the annual plan change period the effective date of enrollment shall be the first (1st) day of the second (2nd) month after the annual plan change period ends or as determined by the department. (g) For all other changes from one health plan to another, the effective date of enrollment shall be UNOFFICIAL 1720.1-12 the first (1st) day of the month following the date on which the department authorizes the enrollment change. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §§430.25, 438.50) (Imp: HRS §346-14; 42 C.F.R. §§430.25, 438.50) §