Fla. Admin. Code Ann. R. 64I-2.002 - Client Eligibility

(1) The governmental contractor or the provider will determine and approve client eligibility based on one of the following three eligibility groups:

(a) Individuals eligible for services under Medicaid when a provider is not available and who meet the program income eligibility requirements.

(b) Individuals whose family income does not exceed 200 percent of the federal poverty level.

(c) Individuals who are clients of the department, that volunteer to participate in the program, and who meet the program income eligibility requirements.

(2) In order to be eligible, an individual shall not have medical or dental care insurance for the illness, injury, or condition for which medical or dental care is sought.

(3) The governmental contractor or provider is responsible for determining if applicants meet the eligibility criteria as established in the Client/Patient Eligibility and Referral Process Training Guide, DH 1032G (12/14), as incorporated herein by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-05465, for participation in the Volunteer Health Care Provider Program.

(4) Applicants shall furnish the governmental contractor or provider information regarding the gross family income for the family unit, child care expenses, and child support payments. The applicant's self declaration of income and expenses is acceptable for eligibility determination, and shall be documented on the Volunteer Health Care Provider Program Eligibility form, DH 1032E, (12/14), which is incorporated by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-05466. The governmental contractor or provider may verify income and expenses for the four week period prior to the date of application. Additional verification for the preceding 12 month period may be requested if the income for the four week period is not representative of the family income and the additional information is in the best interest of the applicant.

(5) An applicant shall not be referred to a health care provider until the governmental contractor or provider determines the individual to be eligible and provides the applicant with a completed patient referral form. The Patient Referral Form, DH 1032, (12/14), is incorporated by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-05467.

Notes

Fla. Admin. Code Ann. R. 64I-2.002

Rulemaking Authority 766.1115(11) FS. Law Implemented 766.1115 FS.

New 1-20-93, Formerly 10D-122.003, Amended 4-11-06, Formerly 64F-11.002, Amended by Florida Register Volume 41, Number 111, June 9, 2015 effective 6/24/2015.

New 1-20-93, Formerly 10D-122.003, Amended 4-11-06, Formerly 64F-11.002, Amended 6-24-15.