NA Categorical Eligibility - Effecting Changes
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This section includes information about what happens when a change in circumstances results in a change to the NA budgetary unit’s categorical eligibility.
Policy
A change in circumstances for the NA budgetary unit may result in any of the following:
●A change in the type of categorical eligibility (from BCE to ECE). This may occur when one or more participants in the budgetary unit stops receiving CA, BIA GA, or SSI. When the budgetary unit does not include a participant, who meets the NA definition of elderly or disabled, AZTECS determines ECE.
●A loss of categorical eligibility (the budgetary unit is no longer categorically eligible under any type of categorical eligibility). Loss of categorical eligibility includes, but is not limited to any of the following:
The NA lead participant is disqualified for noncompliance with the work requirements. When this occurs, the entire budgetary unit is ineligible to receive NA benefits during the disqualification period.
An NA participant is disqualified.
The Basic or Expanded categorically eligible budgetary unit fails or refuses to provide necessary information to complete an NA determination. This includes SSN requirements.
The Expanded categorically eligible budgetary unit’s gross income exceeds 185% of the current federal poverty level, resulting in NA case closure.
Verification
System interface and the case file(g) must be reviewed before verification is requested. No additional verification is needed when AZTECS interface or HEAplus hubs have identified the participant has already verified the eligibility factor.
The participant has the primary responsibility for providing verification. (See Participant Responsibilities – Providing Verification for additional policy.)
Legal Authorities
Prior Policy
last revised 09/27/2022