Arizona Administrative Code
Title 6 - ECONOMIC SECURITY
Chapter 6 - DEPARTMENT OF ECONOMIC SECURITY - DEVELOPMENTAL DISABILITIES
Article 13 - COORDINATION OF BENEFITS; THIRD-PARTY PAYMENTS
Section R6-6-1301 - Information Required at Initial Application and Redetermination

Universal Citation: AZ Admin Code R 6-6-1301
Current through Register Vol. 30, No. 12, March 22, 2024

During the initial application process and at each redetermination for eligibility, the applicant shall provide the Division with information on all health insurance which covers, or is available to cover, the person to receive services including, but not limited to, the name of the policyholder, the policyholder's relationship to the person to receive services, social security number of the policyholder, the name, phone number, and address of the insurer, the policy number, and extent of insurance coverage.

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