Who May Apply

Anyone may apply for Medical Assistance benefits, including the following individuals:

the individual requesting assistance

an authorized representative (AREP) acting on behalf of the applicant. The AREP can be a relative, friend, guardian, or any person in a position to know the applicant’s circumstances. An elected AREP may have verbal or written designation. If the designation is written, the applicant’s signature is required.

the parent, specified relative or individual who provides/provided care and control of a child or deceased individual

an individual acting on behalf of an AU, including a representative of a private law firm or cost recovery company

a child requesting assistance for himself/herself

a Medicaid provider, via Newborn Eligibility Certification Form or via the web portal. DMA Form 550 is no longer used. DMA Form 551 is used for twins only.

The applicant/recipient (A/R) is the primary source of information for him or herself. The A/R may authorize an AREP to apply and provide information on his or her behalf. An elected AREP may have verbal or written designation. If the designation is written, the applicant’s signature is required. If the designation is verbal, it must be documented. If information provided by the AREP is questionable or unclear, attempt to contact th A/R for clarification. This may be accomplished either by telephone, mail, or in-person.

A face-to-face interview is NOT a requirement of any Medicaid Class of Assistance (COA).

The A/R may withdraw, at any time, authorization of an AREP to act on his or her behalf. This request can be given verbally or in writing. If the request is given verbally, it must be documented. If the request is written, the applicant’s signature is required.

An application may be filed on behalf of a deceased individual. Refer to Section 2068 - Special Considerations .