Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1713.1 - NOTICES
Section 17-1713.1-4 - Notice content
Universal Citation: HI Admin Rules 17-1713.1-4
Current through February, 2024
(a) A notice of approved eligibility includes, but is not limited to:
(1) The basis and effective date of
eligibility;
(2) The circumstances
and procedures under which reporting is required;
(3) If applicable, the amount of medical
expenses which must be incurred to establish eligibility for medically needy
spenddown;
(4) Information on the
level of benefits and services approved, including, any premiums, enrollment
fees and cost sharing; and
(5)
Information on administrative appeal rights as described in chapter 17-1703.1
to appeal eligibility or approved level of benefits and services.
(b) A notice to deny or take other action affecting an individual's eligibility or level of benefits and services, based on the individual's household income at or below the applicable MAGI standard shall contain information on the basis for eligibility other than the MAGI standard and how to request a determination on a MAGI-excepted basis.
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