360-10.5 Guaranteed eligibility.
(a) An MCP must provide that a participant who has lost his or her MA
eligibility, due to a change in circumstsnces such that the participant no longer meets
the categorical or financial eligibility requirements of the MA program, before the end of
a six-month enrollment period will have his or her eligibility for MA continued until the
end of the six-month enrollment period; provided, however, MA eligibility will not be
continued for a person who has lost his or her eligibility for Home Relief for failure or
refusal to comply with the provisions of section 131(5) of the SSL. The six-month
enrollment period begins on the date the participant initially selects or is assigned to a
managed care provider and continues for six calendar months. During the period of extended
eligibility, the participant will be eligible only for family planning services and
services provided under the direction of the managed care provider.
(b) Guaranteed eligibility, as described in subdivision (a) of this
section, for participants receiving aid to dependent children and supplemental security
income will continue if and for so long as federal financial participation for
expenditures for services covered by a managed care provider is available.