Page 42

UPDATED: FEBRUARY 2005

492

OTHER ELIGIBILITY REQUIREMENTS DECISION AND NOTIFICATION

WITHDRAWAL OF APPLICATION

Description: After the submission of a written application, but before the applicant is notified by the local social services district of his/her eligibility determination, the applicant may withdraw his/her request for Medicaid. Policy: When an application is withdrawn by the applicant, the district registers it as withdrawn. References: SSL Sect.

366 366-a

Dept. Reg.

358-3.1 358-3.3 358-4.1

Interpretation: The decision to withdraw an application can only be made by the applicant or by the person making the application on behalf of the applicant. When the withdrawal is made in person, the applicant or representative is asked to sign the application as appropriate or sign a statement declaring his/her desire to withdraw the application. When the request is by phone, a notation is made on the application. In addition, an adequate notice is issued to the applicant/representative confirming the voluntary withdrawal. No further action is taken on the application; however, the applicant may reapply at any time. Original documents, such as birth certificates, are returned to the applicant, but any photo static copies and the application remain with the district and are not returned to the applicant.

(MRG)

loading…

Page 42

Official source

UPDATED: FEBRUARY 2005

492

OTHER ELIGIBILITY REQUIREMENTS DECISION AND NOTIFICATION

WITHDRAWAL OF APPLICATION

Description: After the submission of a written application, but before the applicant is notified by the local social services district of his/her eligibility determination, the applicant may withdraw his/her request for Medicaid. Policy: When an application is withdrawn by the applicant, the district registers it as withdrawn. References: SSL Sect.

366 366-a

Dept. Reg.

358-3.1 358-3.3 358-4.1

Interpretation: The decision to withdraw an application can only be made by the applicant or by the person making the application on behalf of the applicant. When the withdrawal is made in person, the applicant or representative is asked to sign the application as appropriate or sign a statement declaring his/her desire to withdraw the application. When the request is by phone, a notation is made on the application. In addition, an adequate notice is issued to the applicant/representative confirming the voluntary withdrawal. No further action is taken on the application; however, the applicant may reapply at any time. Original documents, such as birth certificates, are returned to the applicant, but any photo static copies and the application remain with the district and are not returned to the applicant.

(MRG)