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DE Medicaid - Application Procedures

Medicaid applications are made to the Delaware Division of Social Services (DSS). Applications may be filed by an individual, agency, guardian, or an individual acting for the applicant with his knowledge and consent.

Applicants for Medicaid must:

·      Provide their Social Security number;

·      Confirm they are Delaware residents;

·      Confirm U.S. citizenship or provide documentation of alien status;

NOTE: Rules concerning alien status can be found in the DSS Policy Manual (Sects. 14300 & 14320).

·      Verify income and resources;

·      (Optional) Submit bills for medical services received in the past three months.

The filing date of the application is used to determine the earliest date for which Medicaid can be effective. Medicaid eligibility is effective the first day of the month if the individual was eligible at any time during that month and providing the individual was a Delaware resident on the first of the month.

All applicants who apply for Medicaid on the basis of disability receive a notice of acceptance or denial within 90 days, and all other applicants are notified within 45 days.

Eligibility for continued Medicaid coverage must be re-determined at least annually. Eligibility must be promptly re-determined when information is received about changes in a recipient's circumstances that may affect his or her eligibility. Examples are: Social Security changes, receipt of Child Support, and return to work, among others.

Certain eligibility groups are required to provide verifications, such as age, household composition, and medical eligibility/disability. DSS informs applicants about specific verifications that may apply to them.

Rules require households to file an application to apply for benefits for not only new households but also households that have recently been determined ineligible. DSS was approved to waive these rules to allow eligibility staff to reinstate closed households without a new application if the household reports and verifies a change in circumstances within 30 days of the date the household became ineligible. This waiver will apply to food stamp, cash assistance, child care and Medicaid cases. This waiver became effective on May 11, 2005 and expires on February 28, 2007.

See also:

DE Medicaid - Covered Groups

DE Medicaid - Eligibility

DE DSS - Change Reporting Requirements

DE DSS - Contact Information

Source:

DSS Policy Manual (Sects. 14100, 14500,14510, 14520, 14530, 14700, 14710, 14720)

DE DSS Administrative Notice A-12-2005

Back to:

DE Medicaid - Overview

DE Division of Social Services - Overview

DE Benefit Information System Overview

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