New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 69 - AFDC-RELATED MEDICAID
Subchapter 2 - THE APPLICATION PROCESS
Section 10:69-2.2 - Provisions governing the initial contact
Universal Citation: NJ Admin Code 10:69-2.2
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The application process begins with an individual's initial contact with the agency and ends with a decision by the CWA as to the eligibility for AFDC-related Medicaid. Both the applicant and the eligibility worker have an affirmative responsibility in verifying and documenting eligibility.
(b) Initial contact may be an inquiry, a referral or an application:
1. Inquiry means
any request for information about medical assistance programs, which is not a
request for an application. A record is necessary only when the inquiry
requires follow-up action.
2.
Referral means a request from a public or private agency or individual for
medical assistance on behalf of another individual. All referrals shall be
recorded with appropriate facts, and the disposition noted.
3. Application means a written request for
AFDC-related Medicaid by natural or adoptive parent(s), parent-person(s),
parent-minor, or responsible person acting on his or her behalf.
(c) There are five types of application:
1. A written request for medical
assistance by an individual who has never previously applied under that program
in any county in the State;
2. A
written request for medical assistance by an individual who has previously
applied for, but never received, assistance under that program in any county in
the State;
3. A written request for
medical assistance by a individual who has previously received assistance under
that program in any county in the State, that is, a reopened
application;
4. A written request
for medical assistance from an individual who is presently receiving
AFDC-related Medicaid under the same program in another county in the State;
and
5. AFDC-related Medicaid
applicants may be eligible for retroactive Medicaid benefits. The eligibility
worker shall ask if the family has unpaid medical bills from the three months
prior to the month of application and will provide the applicant with
appropriate forms.
Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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