Open, Processing, Verification Needed
Pending, Denied, Confirmed
Processing, Verification Needed, Closed
Enrolled, Verification Needed, Open
When Medicaid is approved. The effective date can be any day of the month.
When Medicaid is approved. The effective date is always on the first of the month.
As soon as the applicant applies for Medicaid, even if the status is "Processing".
The following month. The recipient will have FFS for the first month.
Express Enrollment-Initial Enrollment MMA
Express Enrollment-Plan Change MMA
The Medicaid application is active, it's just not reflecting in HealthTrack yet.
Medicaid is active and the recipient can use FFS while they wait for the plan to start.
The plan is active and the recipient can start receiving services.
The Express enrollment request is active and waiting for eligibility to be approved by DCF.
Tell the caller you don't have the information, they will receive a letter with the plan and PCP information in a couple of days.
Tell the caller to verify on the Express Enrollment website.
Use the Express Enrollment Search to confirm the plan and PCP chosen.
Use the Call Search to find out when the caller last called us and read the notes.
Go ahead and assist the caller since they are already on the phone with you.
Tell the caller you cannot assist because you only complete express enrollments.
Tell the caller you can call them back at a later time.
Tell the caller to visit the SMMC website for more information.
It starts on the first of the month of when the managed care plan becomes effective.
It starts on the initial effective date of the managed care plan.
It starts the following month after the managed care plan becomes effective.
It starts after the 30 day change period.
Social Security Number and Medicaid ID
Tax ID and Date of Birth
Medicaid ID and Date of Birth
Social Security Number and Date of Birth
If the special condition is active and on file, then the specialty plan will be available on the express website. If not on file, then tell the caller how they can have the special condition added to their file.
All specialty plans will be available to all applicants regardless if the special condition is on file.
Specialty plans will not be available on the express website. Once eligible, the recipient will have 120 days to change to a specialty plan.
To enroll in a specialty plan on the express website, the applicant must first fax documentation of their condition to DCF. DCF will add the special condition to the Medicaid application.
Complete the Express Enrollment because the caller states they were approved for Medicaid.
Refer the caller to the Affordable Care Act Helpline to apply for benefits.
Refer the applicant to DCF to check on their application.
Place the information on the discrepancy log for further research.
Tell the caller they didn't choose a plan, therefore they were assigned to a plan. Explain they have 120 days to change the plan.
Check the Express Enrollment Search in HealthTrack to determine if the caller chose a plan on the express website. Double check the personal information to determine if there was a typing error when the information was submitted and explain to the caller.
Complete another express enrollment; it will override the current enrollment.
File a complaint against the system. The enrollment should have processed.
A confirmation letter will be sent as soon as the express enrollment is completed.
A confirmation letter will be sent when the plan becomes effective.
A confirmation letter will be sent on the first of the month.
A confirmation letter will be sent after 30 days.
The Express Request was converted to a MMA Pending Enrollment Request because the Recipient gained MMA eligibility.
The Express Request was converted to an auto assignment because it took too long to receive eligibility.
The Express Request was converted to inactive because the applicant was approved for KidCare.
The Express Request was converted to a comprehensive plan since the applicant was eligible for MMA and LTC.