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COMAR 10.09.24.04
303 State of Maryland Medical Assistance Manual Revised July 2012
400.1 Introduction -Application Process (Form)
An individual interested in applying for Medical Assistance (MA), or a representative may contact the Local Department of Social Service (LDSS) or Local Health Department (LHD) or go online at www.marylandsail.org to complete the appropriate application form, based on the type of coverage requested. The MA application form is the instrument which information pertinent to the determination of eligibility is gathered from the Applicant/Representative (A/R) or the A/R’s representative. DHMH designates which forms may be used as MA applications and which forms establish the application date. Screening forms, such as the DHR/FIA Cares 9711 Request for Assistance, are not approved by DHMH as MA application forms.
A person requesting to file an MA application must be given an opportunity to apply without delay. The application must be made available to the person upon request.
The individual must complete the application and mail, fax or hand delivers it to their LDSS or LHD where they live. Addresses of the LDSS or LHD are located in Appendix A and Appendix B.
Applicants can also send your applications electronically through the Service Access & Information Link (SAIL) system at www.marylandsail.org.
An individual who temporarily leaves the state but intends to return may apply by mail.
In the case of a deceased person who did not apply before he/she died, a representative may complete, sign, and file an application on his or her behalf. Example: Died 7/2/2007 has bills for April, retro would be for April/May/June (retro would only be for the requesting month). Certification would end the date of death 7/2/2007.
If an individual need help applying for benefits, have questions, or do not speak English and need free translation services, please call 1-800-456-8900 or 1-800-332-6347. Si necesita ayuda para Llenar el formulario favor de llamar al 1-800-456-8900 o 1-800-332- 6347. The individual must be made aware of the significance of the date of application and its effect on retroactive eligibility, and be provided a list of basic information required.
(a) Provisions of Public Information
If anyone request public information about their MA eligibility or the process, the Case Manager (CM) must provide the following information orally or in writing:
Available MA services MA requirements Income Policies/Spend down explanation Case manager never make a determination over the phone or without gathering all of the information.