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MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD D-305 REQUESTS FOR AN APPLICATION The applicant or their representative may request an application by contacting customer service, the district office or downloading an application from the Division’s web page at www.dwss.nv.gov. Applicants should be encouraged to visit accessnevada.nv.gov to complete an online application for medical assistance. Form 2960, Application for Health Insurance should be provided to anyone requesting medical assistance for non-elderly, non-disabled individuals and families. Form 2920, Application for Assistance to Aged, Blind and Disabled (MAABD) should be provided to anyone requesting medical assistance for aged, blind or disabled individuals. Individuals applying for medical assistance under the specialized groups should apply using the specialized applications for each group. (See Medical Assistance Manual [MAM] D-200 Specialized Group Application Processing). D-305.1 Forms Given to the Customer with Application 1. 2179-EE Interface Consent Form 2. NMO 6160-E Medicaid Estate Recovery Notification of Program Operation D-310 APPLICATION ASSISTANCE If an individual needs help completing the application or redetermination, a volunteer or staff member must help. Anyone helping complete the application form must initial the parts completed or sign the form showing they helped complete it. D-315 FILING THE APPLICATION The application date is the day the district office receives an application form containing the applicant’s name, address, and appropriate signature. Applications received by the Division outside of normal business hours, through electronic sources such as Access Nevada, the Exchange, or local office drop boxes, are considered received and date stamped the next business day. This is the first (1st) day these applications are available to the Division for processing. D-320 WITHDRAWAL OF APPLICATION An applicant and/or A/R may voluntarily withdraw an application any time before a case decision is made. D-325 REGISTRATION OF THE APPLICATION All applications must be entered into the system in a timely manner. Pending applicants must be registered in the system to ensure medical providers and other agencies/states can obtain correct eligibility information. D-305 MAABD APPLICATION PROCESSING Division of Social Services Medical Assistance Manual 14 Aug 25 MTL 11/25 REQUESTS FOR AN APPLICATION