Discontinuing Benefits Due to Death

 

When a Deceased Person is the Case Head with Active Dependents

 

Follow the steps below to end medical coverage for a consumer who has died:  

 

  1. Go to the deceased consumer's Individual Demographics page.  

  2. Enter the consumer's date of death (DOD) in the Deceased Date text box using the <mm/dd/yyyy> format or the calendar icon.

 

NOTE: If notification of death is received via an interface Task, the DOD will be mapped in Pending status.

 

  1. A Verified box displays; select Verified from the drop-down menu.

  2. Click the Save and Return button.  

  3. From Task Navigation, click the Run EDBC hyperlink.  

  4. Select the Come-Up Month from the Benefit Month drop-down menu.  

  5. Click the Select button.  

  6. Select and/or de-select the appropriate Program check box(es).

  7. Click the Run EDBC button on the right side of the page.  The EDBC List page displays.  

  8. Click the Medical hyperlink for the Come-Up Month.  The Medical EDBC Summary page displays.  

  9. Validate that deceased consumer has the following values:

EDBC Type: Regular

Role: MEM

Status: Discontinued

Status Reason: Deceased

If the above values are present for the deceased consumer, click the Accept button.  The EDBC List page displays.

 

NOTE: If the values aren't correct, click the Cancel button, check the deceased consumer's Individual Demographics page, and ensure that you have the correct Come-Up Month.

 

  1. Click the Save & Return button to save the EDBC results.   

  2. Add a new Household Status Detail Record with the status of “Permanently Out of the Home” with the DOD as the begin date.

    1. This should automatically end-date the previous record the date before the DOD.

 

NOTE: If the only active coverage on the case is the deceased individual, do not run EDBC for the month of death or any subsequent issued months.  EDBC should only be run for the Come-Up Month.  If other people have active coverage on the case, EDBC must be ran for the current month through the come-up month (in order) for each active program block to ensure the remaining case members’ coverage feeds into MMIS.

 

NOTE: See Consumer Passes Away for discontinuing Working Healthy Programs due to Death.

 

NOTE: See Troubleshooting Non-Financial Data Collection if the wrong Deceased Date was entered or if a Deceased Date was applied to the wrong person in KEES.

 

NOTE: Review the case for additional actions related to the death that may be needed when a consumer is deceased, and other case members have active coverage. Income and Resources may have changed amounts or ownership. The deceased individual may have been the case head and/or responsible party for a dependent. See When a deceased person is the case head with active dependents for further information.

 

Ensure any needed changes that impact the determination are addressed, as outlined by existing processes.

 

If the deceased member is the only HH member on an Medically Needy Spenddown, please see instructions:  Shortening a Base Period and Discontinuing a Medically Needy Case Due to Death