DHS Search Results
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Medicaid: Forms and Publications
… for the Elderly, Blind, or Disabled Application Packet, F-10101 Online using ACCESS They want someone to act on their behalf . This can be a person or an organization. Learn more from the … having a child. Paper— Medicaid Change Report, F-10137 Online using ACCESS They need to allow someone to see information about their eligibility . Use the Release of Confidential Information … -
Suspension of Benefits for Incarcerated Members: Frequently Asked Questions
… they had to complete the full application again to regain health care coverage. When someone's BadgerCare Plus or Wisconsin Medicaid coverage is suspended, their suspension can be … that should not have been covered during the time they should have been suspended. When someone is suspended and remains part of a household, does that person still count as a member of … -
ACCESS Handbook Release 17-02 Cover Sheet
… Expenses 2.1615 Medical Expenses 2.17 Assets Help screenshot If the user indicates that someone living in his or her home has assets, the Assets page will be displayed. The screenshot … questions will appear when there has been a request for FoodShare and will help determine if someone can get this faster service. Some of the answers (for example, income and housing … Information This section is new. (The subsequent sections have been renumbered.) 3.2.4.1.6 Someone Moved Out of Your Home The screenshot has been updated. 3.2.4.1.7 Someone Moved into Your … -
Child Care Coordination Family Questionnaire
… children ever been emotionally or verbally abused by the father of the baby, your partner, or someone close to you? No Yes = (70) 4. Does the father of the baby (or your partner) … (5) 12. How often do you spend time with friends or relatives? Never = (10) 13. Do you have someone you can talk with when you need to? No = (20) Yes 14. Do you find yourself feeling … 15. Is there anyone you can count on in case of an emergency? No = (10) Yes 16. Is there someone who could help you for as long as you needed their help? No Yes 17. Do you or others … -
Suspension of Benefits for Inmates Webinar Presentation
… may not pay for health services provided to incarcerated individuals, with the exception of someone who is outside of prison or jail for 24 hours or more (e.g., when admitted as an … BadgerCare Plus and Medicaid had a longstanding policy of terminating eligibility when someone was incarcerated and requiring a new application upon release. New Policy • The SUPPORT … General Information on Suspension Suspension Length • There is no limit to how long someone’s benefits can be suspended, as long as they continue to meet program rules. Covered … -
Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet
… Security Numbers are used only for the direct administration of the Medicaid program. If someone in your household is not applying for Medicaid, you do not need to provide Social … Services (USCIS) for people in your household who are not applying for assistance. If someone in your household is not applying for Medicaid, you do not need to answer this question … F-10137, of this application packet for future use. If you are completing this application for someone else, complete either the Appoint, Change, or Remove an Authorized Representative: Person … -
ForwardHealth Enrollment and Benefits Handbook
… rules. Fraud means getting benefits or assistance you know you should not get or helping someone else get benefits or assistance you know that person or their household should not get. … the amount you owe to an amount you can repay in three years. An authorized representative or someone who otherwise causes an overpayment or engages in trafficking may also be held … ForwardHealth card to get health care services or prescription drugs for yourself. • Let someone else use your ForwardHealth card to get health care services or prescription drugs. Page … -
MEH Release 15-01 Cover Sheet
… A guardian signs for him/her. Guardian: When an application is submitted with a signature of someone claiming to be the applicant’s guardian, obtain a copy of the document that designates … guardian of the person and the estate, or guardian in general may sign the application. When someone has been designated as the guardian of the estate, guardian of the person and the estate, … or 2. An Authorized Representative: signs for the applicant. The applicant may authorize someone to represent him/her. An authorized representative must be an individual, not an … -
Sample Notice of Decision for FoodShare, Health Care, and Caretaker Supplement
… is not enrolled? When? Which plan? Who and why? As of DATE BadgerCare Plus ANNA, BILL: You or someone in your household did not give all the information your agency needed to process your … change, or renewal. See the "What was needed?" section for more details. ANNA, BILL: You or someone in your household did not take a needed action or give the required proof of your answers … Benefits Who will not get FoodShare and why? When? Who and Why? DATE - DATE ANNA, BILL: You or someone in your household did not give all the information your agency needed to process your … -
Prenatal Care Coordination Pregnancy Questionnaire Instructions
… — *Have you ever been physically, sexually, emotionally, or verbally abused by your partner or someone close to you? Check the box to indicate yes or no. Follow-Up Assessment (To Be Conducted … (a) In the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone? (b) Since you have been pregnant, have you been hit, slapped, kicked, or otherwise physically hurt by someone? (c) Within the last year, has anyone made you do something sexual that you did not want … -
Medicaid Eligibility Handbook Release 22-03
… the Asset Is Transferred ................................................ 262 17.2.7.25 Adding Someone as an Additional Owner of an Asset ..................................................... … a health care program must sign an application or program request for health care. If they or someone else in the household is already open for a health care program, they can request another … on behalf of the applicant: 1. Guardian When an application is submitted with a signature of someone claiming to be the applicant’s guardian, obtain a copy of the document that designates … -
Medicaid Eligibility Handbook Release 21-03
… the Asset is Transferred ................................................ 256 17.2.7.26 Adding Someone as an Additional Owner of an Asset ..................................................... … can be one of the following: • Guardian: When an application is submitted with a signature of someone claiming to be the applicant’s guardian, obtain a copy of the document that designates … her behalf. Only the person designated as one of the following may sign the application: When someone has been designated as the guardian of the estate, guardian of the person and the estate, … -
Health Care Renewal Case Summary Example
… 01/2014 2014 You told us no one in your home makes money by providing room and/or meals to someone living in your home. You told us no one in your home gets money from a source other than … of Housing and Urban Development (HUD). You told us no one in your home makes payments to someone living in another household, such as child support, maintenance, alimony, guardian fees, … in the last four months or has unpaid medical bills. You told us no one in your home pays someone to provide care for a child or adult who lives in your home. You told us no one in your … -
45-day renewal letter with PPRF
… 01/2014 2014 You told us no one in your home makes money by providing room and/or meals to someone living in your home. You told us no one in your home gets money from a source other than … of Housing and Urban Development (HUD). You told us no one in your home makes payments to someone living in another household, such as child support, maintenance, alimony, guardian fees, … in the last four months or has unpaid medical bills. You told us no one in your home pays someone to provide care for a child or adult who lives in your home. You told us no one in your … -
Successful administrative renewal letter with case summary
… of Housing and Urban Development (HUD). You told us no one in your home makes payments to someone living in another household, such as child support, maintenance, alimony, guardian fees, … in the last four months or has unpaid medical bills. You told us no one in your home pays someone to provide care for a child or adult who lives in your home. You told us no one in your … for self-employment tax. Tax Year 2015 Person Filing Status Claimed as tax dependent by someone outside the home Dependents Claimed for this year only ANNA Age: 35 JOE Age: 37 MARRIED … -
Medicaid Eligibility Handbook Release 21-02
… can be one of the following: • Guardian: When an application is submitted with a signature of someone claiming to be the applicant’s guardian, obtain a copy of the document that designates … o Guardian of the estate o Guardian of the person and the estate o Guardian in general When someone has been designated as the guardian of the estate, guardian of the person and the estate, … to be the authorized representative. • Authorized Representative: The applicant may authorize someone to represent him or her. An authorized representative can be an individual or an … -
Medicaid Eligibility Handbook Release 21-01
… can be one of the following: • Guardian: When an application is submitted with a signature of someone claiming to be the applicant’s guardian, obtain a copy of the document that designates … o Guardian of the estate o Guardian of the person and the estate o Guardian in general When someone has been designated as the guardian of the estate, guardian of the person and the estate, … to be the authorized representative. • Authorized Representative: The applicant may authorize someone to represent him or her. An authorized representative can be an individual or an …