Reasons for Plan Termination

• Approved for Medicaid coverage
• Approved presumptive eligibility for SSI
• Coverage by other insurance company (Medicaid, Medicare, Commercial)
• Excess Income
• Excess Assets
• No longer a Polk County resident
• Undocumented Alien Status
• Deceased
• Nursing Home Placement
• Incarceration – effective immediately upon incarceration (Seven day notice not required by the Plan)
• Fails to provide required documentation for Plan eligibility.
• Voluntary termination – Client no longer wishes to participate.
• Misconduct such as altering Plan identification cards, written prescriptions, acts or threats of violence to Polk County staff, providers, medical office personnel, etc.
• Requested to be removed from a physician panel (Primary Care Physician or Specialty Care Physician) more than three (3) times.