Conn. Agencies Regs. § 17a-392-10 - Application process

Current through March 4, 2022

1. An applicant is responsible for completing the application forms legibly and accurately, answering all questions fully, and presenting to the department all necessary documentation in regard to residence, income, and enrollment in Medicare Part B.
2. An applicant is also responsible for the following:
i. Reading the certification and authorization statement on the application form.
ii. Signing or marking the application form.
iii. Obtaining the signature or mark of the spouse, if the income of the spouse is included, and the signature of the preparer, if any, on the application form.
iv. Submitting the completed application forms to the Department.
v. Assisting the department in securing evidence which corroborates the applicant's statements when necessary.
(b) Applicants who do not consent to and assist with a review by the department of information submitted by the applicant, may be denied eligibility.
(c) Applicants who anticipate an immediate need for medical care which would be covered under the program may request expedited processing of their applications by the Department. Any such request shall be made in writing and shall contain a signed statement by the applicant, that he or she is in immediate need of medical care. When expedited processing is requested as provided herein, the Department will make an eligibility determination within three (3) business days of receipt of the application.


Conn. Agencies Regs. § 17a-392-10
Effective December 17, 1992

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