Title 16
16000 Federal Poverty Level Related Programs
A written application must be completed and signed by the applicant or someone acting responsibly for the applicant. If the applicant is a minor (under age 18) and living with his or her parents or guardian, the parent or guardian must sign the application. An emancipated minor as defined in this section is permitted to complete and sign the application. (See DSSM 16220.2.3 )
Filing an application gives the applicant the right to receive a written determination of eligibility and the right to appeal the written determination. The filing date of an application is the date on which DSS receives an application or request for Medicaid. When an application is received in the mail, the date of the postmark is considered the date of receipt. A postmark is the U.S. Postal Service mark stamped on a piece of mail canceling the postage stamp and recording the date and place of sending.
The application filing date is used to determine the earliest date for which Medicaid can be effective. The Medicaid effective date is affected by the application filing date and the date the applicant meets all factors of eligibility. Medicaid eligibility is effective the first day of the month if the individual was eligible at any time during that month.
16200.1 Protected Filing Date
An individual’s Medicaid application filing date may be established based on either a written statement or an oral inquiry about Medicaid eligibility. An oral inquiry is a discussion about Medicaid eligibility for a specific person that results in a request for Medicaid. An oral inquiry must be documented when received. An oral inquiry or a written statement protects the filing date if a written application is completed and received in a DSS office within 30 days from the date of inquiry. When an application is received in the mail, the date of the postmark is considered the date of receipt. A postmark is the U.S. Postal Service mark stamped on a piece of mail canceling the postage stamp and recording the date and place of sending.
An application filing date may be established at locations other than a DSS office provided the request for Medicaid is documented and forwarded to a DSS office.
Examples of other locations include but are not limited to clinics, hospitals, social service agencies, outstation sites, or other government agencies.
The 45-day application processing time standard begins on the protected filing date if one has been established. If no protected filing date has been established, the 45-day time standard begins on the date of receipt of the application.
