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MEDICAL SERVICES POLICY MANUAL,SECTION C C-100 Application Process
C 112 Authorized Representatives
provide information regarding health benefit plans or coverage offered through the Marketplace and will facilitate enrollment through the Marketplace. An In-Person Assister will assist individuals enrolling through the Marketplace by educating people about the new system, helping them understand about their health plan choices and facilitating the selection of a plan that is right for them. A Certified Application Counselor is a licensed person authorized to assist individuals in enrolling in different marketplace designated organizational settings including healthcare facilities. It is the duty of Navigators, In-Person Assistors and Certified Application Counselors to assist individuals completing an application for healthcare benefits. They do notmeet the definition of an Authorized Representative as outlined in MS C-112 unless the applicant has designated the individual as an Authorized Representative.
C-112 Authorized Representatives MS Manual 01/01/14 An authorized representative is: 1. An individual or facility designated by the client, in writing, as authorized to request and receive confidential information that would otherwise be disclosed only to that client; or 2. An individual or facility identified by the court when the client is mentally, physically or legally unable to designate a representative; or 3. An individual designated by an inmate of the Department of Corrections, Community Corrections or a local correctional facility for purposes of filing a Medicaid application and complying with Medicaid requirements for determining eligibility; or 4. The Department of Corrections, Community Corrections or a local correctional facility when an inmate who has received medical services that meet the criteria for Medicaid coverage does not designate a representative within three business days following a request to designate a representative or the inmate’s assigned representative does not file a Medicaid application within three business days after appointment as that inmate’s representative.