What happens when a change occurs that affect my patients eligibility for benefits? How do unpaid premiums affect eligibility?
A. Your patient must report changes to his or her worker that affect eligibility. If you patient’s situation changes, his or her eligibility for medical assistance may change. As a result, your patient may become ineligible for medical assistance or may become eligible for a different program with a different benefit package. When this occurs, the worker will send a notice to your patient telling how eligibility has changed. Eligibility may change from the program that provides the OHP Standard benefit package to a program that provides the OHP Plus or OHP with Limited Drug benefit package. Medical programs that provide OHP Plus or OHP with Limited Drug do not require premiums. Unpaid premiums do not affect eligibility for programs that provide OHP Plus or OHP with Limited Drug. If the worker is evaluating your patient’s eligibility for OHP Standard and he or she has outstanding premiums, your patient will have to pay those premiums before qualifying again for OHP Standard. Unpaid prem
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