All Medicaid Programs |
Obsolete Policy |
Special Notice: Effective March 18, 2020 until the end of the Health Emergency due to COVID-19, refer to the Q&As in this manual for special instructions about:
· Applications received from testing sitesfor the COVID-19 uninsured testing.
· Applications submitted by an Authorized Representative with the form 114COVID.
The Federally Facilitated Marketplace will accept only the federal single-streamlined application form online or in paper format.
The Department of Workforce Services will accept applications in the following ways.
A. Paper Application for Medical Assistance
1. All paper applications must have an original signature.
2. The agency will accept a signed paper application sent by FAX as an original signature.
3. If the agency receives an unsigned paper application, the agency will send a signature page to the applicant to sign and return. (703-2)
B. Online Applications for Medical Assistance
1. Applicants may apply online.
2. The online application process includes an online signature. The applicant must complete the online signature for the application to be valid.
C. Federally Facilitated Marketplace (FFM) Account Transfers
1. Applicants have the option to apply for medical assistance through the state Medicaid and CHIP agency or the single streamlined application through the FFM.
2. For individuals assessed eligible for Medicaid/CHIP by the FFM, their account is transferred to the state Medicaid/CHIP agency for a final determination. This may include an initial application, a FFM review or a change report through the Marketplace. (See section 220-9 to determine what actions to take to coordinate with marketplace plans.)
D. Electronic Applications from Social Security
Social Security will transmit electronic data to states on applicants for Medicare Part D subsidy programs. This data is an application for the Medicare Cost-Sharing programs. (See Sec. 320-1) The electronic signature meets legal requirement for Medicaid.
E. Non-Medical Review Forms as Applications
1. Households with an open non-medical assistance case may use the review form as an application for medical programs. The review form must be signed.
2. The individual or worker must write on the review form what medical assistance the individual wants.
3. The individual or worker can write a new household member’s name on the review form and state the individual wants to apply for medical assistance for that person. (703-1)
4. The review form with the request for assistance must be submitted to DWS.
F. Telephone Applications
1. Applicants may ask to apply by telephone.
2. If an application is completed over the phone, the eligibility worker will complete the application with a telephonic signature.
3. Document and store in the case record that the application was completed with a telephonic signature.
4. A confirmation receipt will be sent to the applicant via the communication method they have selected.
G. Verbal Request to Add Medicaid to a Pending Application
1. An applicant who has a pending application for other types of assistance may make a verbal request to add Medicaid to the application.
2. The applicant must make the verbal request while the application for other assistance is still pending, and within 30 days of the application date of the pending application. If the 30th day is a non-business day, the applicant has until the first business day following the 30th day to make the verbal request. The date the applicant makes the verbal request to add Medicaid is the date of application for medical assistance.
3. If the agency has approved or denied the application for other assistance, or if it is more than 30 days after the application date, the applicant cannot make a verbal request to add Medicaid. The applicant must submit a new application to request medical assistance.
H. The following situations are considered new applications, but do not require an application form
1. A household with an open medical case can add a new household member by contacting the eligibility agency. Request information about the new household member as needed to determine eligibility. TPL information for the new household member must be requested and the voter registration option must be offered to a new adult household member.
2. When medical assistance ends because the individual did not return requested verification for a change report, the date the individual provides all of the requested verification is a new application date if it is submitted by the last day of the month immediately following closure. A signature is not required. TPL, voter registration and rights and responsibilities information can be waived.
3. If medical assistance ends due to an incomplete review, an individual can re-apply by responding to the review request within 3 months of case closure (707). The response may be a phone call, submission of the review papers (a signature is required for reviews that involve individual participation) or verification documents. TPL, voter registration and rights and responsibilities information can be waived if the worker completed these in the review month.
4. When an application is denied because the applicant fails to provide all requested verification, the applicant may provide all of the requested verification within 30 days of the denial notice date. The date the verification is received is a new application date and sets a new retroactive eligibility period (703-2). No signature is required. TPL, voter registration and rights and responsibilities information can be waived. This does not apply to the programs with open enrollment restriction, such as Adult Expansion and UPP. For these programs, the 30 day period following an application denial must encompass an open enrollment period.
5. If an individual can be eligible as part of the transitional Medicaid household and is sanctioned from Medicaid due to failure or refusal to cooperate with Medical Support Enforcement, include the individual in the transitional Medicaid without an application or request.
6. If a medical assistance case is closed for more than one calendar month, the individual must complete and sign a new application form.
I. Unsigned Applications
If the agency receives an unsigned application for medical assistance, require the applicant to complete the signature page. If the applicant completes and returns the signature page within the application-processing time, retain the date of application. (See 703-2) If the applicant does not return the signature page within the application-processing time, the agency will deny the application.
J. Incomplete Applications
When the application is not complete enough for the agency to determine eligibility, the agency will contact the applicant and offer ways for the applicant to complete the form. The applicant must complete the form by the end of the application-processing period or the agency will deny the application.