Low Income Subsidy (LIS) Applications Procedures

Medicare Part D LIS applications are received on a daily basis through a Business Objects report. Designated clerical staff prints the report, completes file clearance procedures, application registration, and sends the Medi-Cal informational packet with a pre-addressed, postage-paid envelope. In addition, as an outreach effort, the form “Good News for Seniors Receiving Social Security Benefits” (SCD 2329) and a CalFresh application packet must also be included. Refer to MEDS Handbook, Chapter 1, ILIS - LIS Client Inquiry Request for detailed information regarding MEDS screens for the LIS process. 

 

Follow the steps below when the LIS applicant does not have a MEDS record:

Step Who Action
1 Information Systems

On a weekly basis, posts Alerts 9055 and 9056 in a report titled “Low-Income Subsidy Applications” in Business Objects (BO) under Public Folders/DEBS/ AAC_A5 and MBA/Administration.
2 Designated Clerical Staff
  • Prints the “LIS Applications” report from BO daily.
  • Completes file clearance procedures in CalSAWS and MEDS.
    • For applicants that already have an active or pending case, sends an e-mail notification to the current EW and copies the EW Supervisor. On the subject line, enters “Urgent - LIS Alert 9055 or 9056.”
    • For applicants that have an active unassigned case, sends an e-mail notification to the Information Supervisor of the office for urgent application processing. On the subject line, enters “Urgent - LIS Alert 9055 or 9056.”
    • For applicants with the same last name, checks address on the [LIS2] screen to see if they are spouses. If they are, app reg them in the same case.
    • Verify that the application date is correct prior to completing the app reg process.
    • For application dates over 45 days, checks the [LIS5] screen for the Subsidy Approval date to verify the County Referral Date as the correct date of application. 
  • Completes the Application Registration process in CalSAWS.
    • Use the APPLICATION-DATE shown on the [LIS1] screen.
    • In the drop down field, select Other from the Application Source.
    • Assigns the application to Caseload 43LS1RK402.
  • Prints and signs a copy of “Application For Cash Aid, Food Stamps, And/or Medi-Cal”(SAWS 1).
  • Creates a file for Imaging that consists of the following forms and MEDS screens:
    • Application for Cash Aid, FS and/or MC SAWS 1,
    • Primary Medi-Cal/CMSP Information Screen [INQM],
    • Other Client Eligibility Information Screen [INQE],
    • LIS Inquiry, Client Data Screen [LIS1], and
    • LIS Inquiry, Client Information Screen [LIS2].
  • Sends the Medi-Cal Application packet to the applicant which consists of:
    • Medi-Cal Intake Forms,
    • Intake informational packet,
    • SCD 2269 and SCD 2270, and 
    • A pre-addressed, postage paid envelope.

Note: The Medi-Cal Intake forms and Intake Informational forms can be accessed in the DEBS Forms Library under Forms Packets, by selecting the Medi-Cal program. Enter the name, case # and due date (10 calendar days from current date) on the SCD 2269 and SCD 2270.

  • Sends CalFresh applications with the following items:
    • CalFresh application packet (Refer to CF HB Chapter 4 Applicaiton Forms),
    • “Good News for Seniors Receiving Social Security Benefits” (SCD 2329), and
    • A pre-addressed, postage paid envelope (writes LIS on the envelope).
  Client

Returns Medi-Cal or CalFresh application packet(s).
3 Mail-in Application Clerical Staff
  • Conducts application registration if CalFresh packet is returned.
  • Add a Case Flag type "zzzCF-LIS".
  • Creates or updates the Task as needed.

Note: If a SCD 2269 is returned and the case is assigned to an EW a courtesy email is sent to the EW and copies the EW Supervisor. If the case is not assigned and or pending creates or updates the Task as needed.
4 Intake EW
  • Receives the Task.
  • If the client returns the CalFresh application then, follow the procedures for a new CalFresh application.
  • If the client returns Medi-Cal forms then, follow the procedures below to process the LIS application:
If the applicant... Then...
Returns the SCD 2269 and marks that they do not want Medi-Cal or MSP, Denies the application as it is considered a written withdrawal.
Does not return the SCD 2269 or SCD 2270 by the due date OR the mail comes back as returned mail,
  • Contacts the client by phone or in writing and allows 10 calendar days to provide.

Note: Documents in a Journal entry the type of contact and the results.
Returns the SCD 2270 (with or without the SCD 2269), or only the SCD 2269 but marks just one check box,
  • Reviews LIS screens in MEDS and the SCD 2270 questionnaire.
  • Requests additional information and verification from the client, if necessary.
    • Allows 10 calendar days to provide verification.
    • Documents in the Journal actions taken.
  • If the applicant is ELIGIBLE, approves Medi-Cal/MSP using the Application Date shown on the [LIS1] screen.
  • If the applicant is INELIGIBLE, denies Medi-Cal/MSP with an appropriate NOA.

Related Topics

Medi-Cal Business Processes Overview