What does "good cause" mean?
Good Cause for Late Payment
If an MA-EPD premium is not received by the due date, the case will be closed unless the enrollee has good cause or an exemption.
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What does "good cause" mean? |
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Examples of good cause
Some examples of situations that are considered good cause include:
Voluntarily terminating MA-EPD coverage mistakenly believing that other health care coverage was available.
Not receiving a regular source of income to pay the premium.
Serious physical or mental incapacity or illness.
Some other important points to keep in mind:
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Good cause does not exist if the enrollee has chosen to pay other expenses instead of the premium, nor does it forgive the obligation to pay the required premium. |
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Good cause allows an enrollee to make a required premium payment after the due date so MA-EPD eligibility can be approved or continue. |
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Good cause claims are submitted to DHS by sending a written request. |
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Good cause claims require information regarding the circumstances. |
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SRU will make a determination within 30 days and notify the county and the enrollee in writing. The enrollee has the right to appeal if good cause has been denied. |
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How does one find out if the premium is late or overdue? | |
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