Approving TransMed or Extended Med for 18 Year Old

While EDBC is setting the correct CE Date for these 18 year olds, baseline system functionality is setting a program CE for both of these programs (12 months for TransMed and 4 months for Extended Med).

When the 18 year old turns 19 prior to the expiration of the program CE period, the program CE will trump the person level CE.

Example 1: 18 year old is approved for TransMed starting in 1/2016. 18 year old turns 19 on 6/12/2016 therefore EDBC set the CE Date as 6/30/2016. However, the program CE period is set as 1/01/2016 - 12/31/2016.

Example 2: 18 year old is approved for Extended Med starting in 1/2016. 18 year old turns 19 on 3/05/2016 therefore EDBC set the CE Date as 3/31/2016. However, the program CE period is set as 1/01/2016 - 4/30/2016.

When approving TransMed or Extended Med for an 18 year old who turns 19 within the next 12 months (for TransMed) or 4 months (for Extended Med), a special process is required.

TransMed

  1. Select Customer Options from Task Navigation. The Customer Options List page displays.

  2. Click the Add button on. The Customer Options Detail page displays.

  3. Select the consumer’s name in the Name drop-down and then select Transitional Medical in the Type drop-down.

  4. Set the Begin Date to the first day of the month TransMed should be excluded. Example: If the 18 year old turns 19 on 6/12/2016, the Begin Date should be set to 07/01/2016.

  5. Set the End Date to the last day of the program CE period. Example: If the program CE period would be 1/01/2016 - 12/31/2016, the End Date should be set to 12/31/2016.

  6. Click the Save and Return button.

Extended Med

  1. Select Customer Options from Task Navigation. The Customer Options List page displays.

  2. Click the Add button. The Customer Options Detail page displays.

  3. Select the consumer’s name in the Name drop-down and then select Extended Medical in the Type drop-down.

  4. Set the Begin Date to the first day of the month Extended Med should be excluded. Example: If the 18 year old turns 19 on 3/05/2016, then the Begin Date should be set to 04/01/2016.

  5. Set the End Date to the last day of the program CE period. Example: If the program CE period would be 1/01/2016 - 4/30/2016, then the End Date should be set to 04/30/2016.

  6. Click the Save and Return button.