Haw. Code R. § 17-1711.1-21 - Filing an application for medical assistance

(a) The application process shall begin when a completed application for medical assistance is received by the department or designee and ends with the department's issuing an eligibility determination to the applicant.

(b) The application shall be used for all insurance affordability programs and may be submitted according to the applicant's preference by one of the following methods:

(1) Via the department's designated internet web site(s);

(2) By telephone;

(3) Via the United States Postal Service;

(4) In person; and

(5) Through other commonly available electronic means.

(c) The date an application is received by the department or designee shall be considered the date for a determination of medical assistance.

(d) An individual applying for assistance on a basis other than Modified Adjusted Gross Income (MAGI) methodology may be required to provide additional information, as determined by the department, in order to complete an eligibility determination.

(e) The department may request a non-applicant's SSN provided that:

(1) The provision of the SSN is voluntary;

(2) The SSN is used only to determine an applicant's eligibility for Medicaid or other insurance affordability program or for a purpose directly connected to the administration of the State plan; and

(3) At the time the SSN is requested, the agency notifies and ensures the applicant, or person acting on the applicant's behalf, understands that the provision of the non-applicant's SSN is voluntary and how the information regarding the SSN will be used.

(f) The application shall be signed under penalty of perjury by the applicant, adult included in the household for an applicant who is a minor, authorized representative, or an individual acting on behalf of an incompetent or incapacitated applicant in accordance with this chapter.

Notes

Haw. Code R. § 17-1711.1-21

[Eff 09/30/13] (Auth: HRS §§ 346-14, 346-29, 346-53; 42 C.F.R. §435.907) (Imp: HRS § 346-29; 42 C.F.R. §435.907)