An Overview for Community Partners

Size: px
Start display at page:

Download "An Overview for Community Partners"

Transcription

1 An Overview for Community Partners

2 Goals For Today After this training, you should understand: 1) PEAK usage to date 2) Key lessons learned to date 3) What PEAK is, why it was created, and where to find it 4) How community partners can use PEAK to assist clients 5) Available resources & support

3 Goal: To ensure that every eligible individual, child and family in Colorado is screened for and enrolled in the health, food and financial self-sufficiency benefits that help them thrive.

4 What are the current usage numbers for PEAK? *8/9/11

5 Key Lessons Learned From PEAK Thus Far Many adults without children are using PEAK to apply for medical benefits why is this happening? Screener may be confusing as it says they are potentially eligible but doesn t clarify that they need to use the paper application to apply Clients are not reading the definition of Family Medicaid/CHP+ provided in PEAK Clients are selecting all programs Adult medical programs will be added to PEAK 1 st quarter, 2012 Is PEAK being kept up-to-date with CBMS? Yes, PEAK changes are being brought online as CBMS changes so that the two systems continue to speak to one another correctly

6 Key Lessons Learned From PEAK Thus Far Does PEAK send applications to the county of residence or the county of a stated mailing address? County of residence is where PEAK applications and change reports go unless it is medical only application, then it will be processed by MAXIMUS Why do some applications go to another county other than the client s county of residence? There are certain zip codes that are shared between two counties. When PEAK was designed, only one county could be designated as the primary for that zip code. A Business Requirement Document is being circulated for approval to correct this issue and to allow for greater clarity as to where applications are processed

7 Key Lessons Learned From PEAK Thus Far Why doesn t PEAK provide more detailed specific information about where an application is being processed? The zip code enhancement change will allow for greater clarity The zip code enhancement will also allow for selective HMO options in PEAK so clients will only be given the HMOs in their area Counties are receiving a large number of applications for cash assistance from people who are not eligible. Why? The screener is set for a two-parent household with 10 children so it is telling a number of folks that they may be potentially eligible Clients are choosing to apply for all programs without looking at the explanation of who may be eligible for the cash assistance programs

8 PEAK Overview

9 What is Colorado PEAK? New website that allows clients to access self- sufficiency benefit information from any computer with internet access.

10 Overview: PEAK Online Application PEAK is: A data flow tool One more access point for benefits An application form similar to the Single Purpose Application PEAK is not: An eligibility determination tool Applicable for all situations Applicable for all programs A replacement of the county eligibility role

11 1 Colorado Health Institute. Retrieved on November 25, 2009 from ttp://datacenter.coloradohealthinstitute.org/data_results.jsp?i=275&rt=3&p=2&c=2 2 U.S. Census Bureau, American Community Survey. Retrieved on December 13, 2008 from 3 Colorado Children s Campaign 2010 Kids Count Annual Report 4 * Why was PEAK Created? Colorado ranks 48 th for children s health coverage 1 Colorado ranks 48 th for food assistance enrollment 2 Colorado ranks 30 th for percentage of overall population living below federal poverty level 2 Colorado ranks 28 th for child poverty 2 Just 52% of eligible Coloradans are enrolled in food assistance 2 The child poverty rate in Colorado has grown by 72% since this is the fastest growing rate in the US 4

12 Why was PEAK created? Create local access points for health, food & financial benefits Empower clients to screen, apply & manage their own cases Remove barriers to enrollment & renewal for eligible Coloradans Increase efficiencies for county and medical assistance offices

13 What services does Colorado PEAK offer?

14 Overview: What services does PEAK offer?

15 Overview: What services does PEAK offer? 1) Am I Eligible? Screening tool to see what health, food and financial selfsufficiency benefits a client might be eligible for. 2) Apply For Benefits Apply for health, food and financial self-sufficiency benefits online 3) Check My Benefits See details about existing benefits including renewal deadlines 4) Report My Changes Report changes to your existing case (i.e. new contact information or employment details)

16 Step 1: Am I Eligible? Screens for potential eligibility for cash, food and medical assistance Results are immediate Programs include: Colorado Works/TANF Adult Financial Aid to the Blind (AB) Aid to the Needy Disabled (AND) Colorado Supplement to Supplemental Security Income (SSI) Old Age Pension (OAP) Home Care Allowance (HCA) Burial Assistance Food Assistance/SNAP (formerly Food Stamps) All Medical Programs: Family Medicaid/CHP+ Adult Medicaid Long Term Care

17 Step 2: Apply For Benefits Clients can initiate an application for cash, food and medical assistance Only Family Medicaid/CHP+ Clients select programs for which they wish to apply Application asks only questions related to the programs selected Application takes between 30 and 60 minutes to complete

18 Step 2: Apply For Benefits Programs supported include: Colorado Works/TANF Adult Financial Aid to the Blind (AB) Aid to the Needy Disabled (AND) Colorado Supplement to Supplemental Security Income (SSI) Old Age Pension (OAP) Home Care Allowance (HCA) Burial Assistance Food Assistance/SNAP (formerly Food Stamps) Family Medicaid/CHP+

19 Overview: Apply For Benefits

20 Overview: Apply For Benefits

21 Overview: Apply For Benefits

22 Step 3: Check My Benefits Allows people who are currently receiving benefits to access: Current information Renewal date for benefits Simple to use Clients create an account with a user name and password in PEAK and then search for their case NOTE: This is not a status checker it will not give the status of an application being processed for eligibility

23 Check My Benefits

24 Overview: Check My Benefits

25 Step 4: Report My Change Clients easily report changes using any computer with internet access Contact information Pregnancy status Death Employment Additional income Rent/utilities Illness/disability Marital Status Supplies current case information client inputs what has changed Some changes may require document verification Change Reports submitted in PEAK go to the local county office

26 Report My Changes

27 Report My Changes

28 Report My Changes

29 What Happens After an Application or Change Report is Submitted?

30 Where Do PEAK Applications and Change Reports Go for Processing? Applications submitted in PEAK go to one of two places based upon the programs selected in the application: 1. Local county offices for food assistance only, cash assistance only, and all combination cases (Based on zip code entered in the application) 2. Colorado Medical Assistance Program Vendor for medical only cases Change reports go to the local county office.

31 How Do Clients and Community Partners Know Where to Send Verification Documents? The third sentence of the printed application states specifically where an application was submitted for processing. The PEAK tracking number should be on each page of every document sent in for verification

32 How Can You Submit Verification Documents From Clients to the County Each county can receive verification documents in a number of ways: Scanned and ed Mailed Faxed Dropped-off in person Counties will have a preferred method of receiving documents contact your specific county partners for this information.

33 How Do You Send Documents to the Colorado Medical Assistance Program Vendor (MAXIMUS)? Documents may be mailed, faxed, or dropped-off in person. CBOs can also request an account that allows for and fax. To set-up an account, Mail: Colorado Medical Assistance Program P.O. Box 929 Denver, CO Fax : (303) Drop-off: 4500 Cherry Creek South Drive, Ste. 200 Glendale, CO (800)

34 Locating County Offices & Application Assistant Sites

35 ? How Can Community Partners Assist With PEAK?

36 How Can Community Partners Assist? 1. Direct clients to the online site 2. Provide space and computers for clients to apply for benefits online 3. Provide assistance to clients as they initiate an application 4. Guide clients through the application process assisting with documents needed to complete an online application

37 What Does Directing Clients Look Like? 1. Direct clients to the online site: Weld Food Bank provides grocery assistance to clients. As they prepare the boxes for distribution, workers insert flyers with information about PEAK and how clients can apply for benefits in the boxes of food. Weld Food Bank front desk employees are knowledgeable about the online tool and hand a business card with colorado.gov/peak to people inquiring about assistance. The food bank also displays posters and flyers for PEAK in its lobby.

38 How Can You Provide Space? 2. Provide space and computers for clients to apply for benefits online: Coal Ridge High School in Garfield County opens its computer lab after hours for parents to use the computers to access the internet. The computer lab displays posters and flyers about PEAK and online access to benefits.

39 How Can You Help Initiate an Application? 3. Provide assistance to clients as they initiate an application The People s Clinic was awarded a special grant to hire an outreach worker who concentrates on enrolling people for benefits. They assess the needs of clients by using the Am I Eligible screener in PEAK. Based on what they observe and learn from the screener, they use either the online application in PEAK or the paper application to begin the process of applying for benefits.

40 What Does Guiding Clients Through the Process Look Like? 4. Guide clients through the application process assisting with documents needed to complete an online application St. Paul s Episcopal Church provides evening meals for those in need in their local community. As part of this service, they have a caseworker present to provide application assistance and counseling for anyone who wants to apply for benefits. This counselor helps the client complete the application and assists them with pulling together the necessary documentation needed.

41 Questions for You 1. How could PEAK help your clients? 2. What level(s) of engagement would work the best for your organization? 1. Direct clients to the online site 2. Provide space and computers for clients to apply for benefits online 3. Provide assistance to clients as they initiate an application 4. Guide clients through the application process assisting with documents needed to complete an online application 3. What two (2) steps can and will you take this week to begin using PEAK?

42 What Resources Are Available To You?

43 CO PEAK Initiative: Toolkit Elements

44 Optional Weekly Calls During Initial Launch Period Calls will include counties, community partners, PEAK Outreach Team, state agencies, OIT and Deloitte to answer questions in real time. Calls: Mondays, 11:00 AM 12:00 PM Thursdays, 9:00 AM 10:00 AM #

45 Technical Issues with PEAK Phone: Application Questions Local county office for combination cases Medical program assistance vendor for medical only cases For Program Information colorado.gov/hcpf cdhs.state.co.us For Training Questions colorado.gov/peak

46 PEAK Outreach Team Dawn Joyce, MPH Project Director (303) Jacqueline Sullivan, MAIPS Project & Communications Manager (720) Patrick T. Kelly, MPhil Project Manager (720) Tami Agne Project Consultant (303)

47 Thank You!

48 What Are the Advantages of Applying Using PEAK?

49 Advantages to Applicants Self-service option for initiating an application for benefits Available 24-hours/day, 7 days a week Saves application drafts for 30 days Allowing clients to apply during convenient times for them Allows clients to apply from a comfortable environment

50 Advantages to Applicants Acts as a single application to access multiple programs Empowers clients by allowing them to screen for potential eligibility, apply, and make changes online Can be less overwhelming than the paper application Applicants just see one screen at a time Available in Spanish and English

51 Advantages to Community Partners (CBOs) Allows CBOs to provide a wider range of services to clients Allows CBO staff to easily allow clients to screen themselves for potential eligibility thus adjusting the level of assistance offered Provides a tool to help manage the lifecycle of a client Allows CBOs to potentially assist clients in a more sustainable manner Provides potential opportunities to increase funding streams

52 Advantages to Counties & Medical Assistance sites Reduces flow of clients needing to fill out applications in county and MA offices Creates efficiencies for counties and MA sites thereby improving capacity to process applications Reduces data entry for county and MA site workers, leading to fewer errors and time savings Legibility eliminates guess work

53 Advantages to Counties & Medical Assistance Sites Informs clients of potentially required documentation Fewer incomplete applications = fewer call backs Allows clients to report changes and check benefits online Reduced applicant calls and visits to offices E-signature eliminates a major cause of incomplete applications Informs clients of renewal date Quick return of paperwork

Medical Only Application Submitted Online

Medical Only Application Submitted Online Submitted Online Application for Medical Assistance only is submitted online Colorado.gov/PEAK ConnectforHealthCO.com manages case if, CHP+, or Non- Applicant receives real-time eligibility determination

More information

A Quick Guide to Using CommonHelp

A Quick Guide to Using CommonHelp A Quick Guide to Using CommonHelp Introduction CommonHelp is the Commonwealth of Virginia s fast and easy way to apply online for many Virginia social services assistance programs. Through a single online

More information

Medicaid Presumptive Eligibility Instructions for Providers September 2015

Medicaid Presumptive Eligibility Instructions for Providers September 2015 Medicaid Presumptive Eligibility Instructions for Providers September 2015 KC 3767 (R-7-15) 0 MEDICAID PRESUMPTIVE ELIGIBILITY PROGRAM OVERVIEW The Medicaid Presumptive Eligibility (MPE) program is one

More information

To apply for the Colorado HIBI program, fill out the attached application and either fax or mail it with a:

To apply for the Colorado HIBI program, fill out the attached application and either fax or mail it with a: Dear Applicant, The Colorado Health Insurance Buy-In (HIBI) program may reimburse health insurance premiums, copays, deductibles and coinsurance for a Medicaid client if the health insurance plan is cost-effective

More information

IRS Form 1095-B: Health Coverage Q & A Webinar. February 10, 2016

IRS Form 1095-B: Health Coverage Q & A Webinar. February 10, 2016 IRS Form 1095-B: Health Coverage Q & A Webinar February 10, 2016 1 Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources

More information

1. Please describe, briefly, your role in the application process. 4. Does the call center track approval and denial rates by application method?

1. Please describe, briefly, your role in the application process. 4. Does the call center track approval and denial rates by application method? Maximizing Enrollment Self- Assessment Toolkit Stakeholder Questionnaire: Call Center Staff Introduction: Your state has begun to assess its Medicaid and CHIP enrollment and retention policies and procedures

More information

Department of Elder Affairs Emergency Home Energy Assistance for the Elderly Program (EHEAP) Application Instructions Revised April 2014

Department of Elder Affairs Emergency Home Energy Assistance for the Elderly Program (EHEAP) Application Instructions Revised April 2014 Department of Elder Affairs Emergency Home Energy Assistance for the Elderly Program (EHEAP) Application Instructions Revised April 2014 APPLICANT S CIRTS DATA The top section of the front/first page is

More information

WE CAN HELP YOU! DTE ENERGY OFFERS A LOW INCOME SELF- SUFFICIENCY PLAN (LSP)

WE CAN HELP YOU! DTE ENERGY OFFERS A LOW INCOME SELF- SUFFICIENCY PLAN (LSP) WE CAN HELP YOU! DTE ENERGY OFFERS A LOW INCOME SELF- SUFFICIENCY PLAN (LSP) This program allows you to make affordable monthly payments based on your income. The remaining portion of your bill is paid

More information

Health Care Coverage APPLICATION FOR. Health Care in Pennsylvania. Easy, affordable protection for your family

Health Care Coverage APPLICATION FOR. Health Care in Pennsylvania. Easy, affordable protection for your family Important information about health care benefits. Ask someone to read this to you. APPLICATION FOR Health Care Coverage This application may be used by families with children or by pregnant women who apply

More information

THE HOLY CROSS HEALTH FINANCIAL ASSISTANCE PROGRAM

THE HOLY CROSS HEALTH FINANCIAL ASSISTANCE PROGRAM THE HOLY CROSS HEALTH FINANCIAL ASSISTANCE PROGRAM Holy Cross Health Financial Counseling 1500 Forest Glen Road Silver Spring, MD 20910-1484 Phone: (301) 754-7195 Fax: (301) 754-3227 Hours: 7:30 am 6:00

More information

FINANCIAL ASSISTANCE APPLICATION: COVER LETTER

FINANCIAL ASSISTANCE APPLICATION: COVER LETTER FINANCIAL ASSISTANCE APPLICATION: COVER LETTER Thank you for choosing Children s of Alabama to provide for the healthcare needs of your child. Please find attached the forms you must complete in order

More information

Washington County Archway Partnership: Health

Washington County Archway Partnership: Health Washington County Archway Partnership: Health Medicare Outreach Initiative Provide opportunities for older adults (and their caretakers) in the Washington County area to choose the Medicare coverage option

More information

Understanding The Benefits

Understanding The Benefits Understanding The Benefits 2015 Contacting Social Security Visit our website At our website, www.socialsecurity.gov, you can: Create a my Social Security account to review your Social Security Statement,

More information

GEORGIA YOUR GUIDE TO PUBLIC BENEFITS IN

GEORGIA YOUR GUIDE TO PUBLIC BENEFITS IN WORKING WITH STRUGGLING RESIDENTS 50+ TO WIN BACK OPPORTUNITY INFORMATION TO HELP YOU: Increase your income Save money on prescription drugs Pay doctors bills Buy groceries Cover other basic costs YOUR

More information

can provide you with medical insurance for your entire family

can provide you with medical insurance for your entire family Affordable health coverage. Quality care. can provide you with medical insurance for your entire family You may be able to receive NJ FamilyCare, free or low-cost health insurance for adults and children

More information

CONNECTICUT YOUR GUIDE TO PUBLIC BENEFITS IN

CONNECTICUT YOUR GUIDE TO PUBLIC BENEFITS IN WORKING WITH STRUGGLING RESIDENTS 50+ TO WIN BACK OPPORTUNITY INFORMATION TO HELP YOU: Increase your income Save money on prescription drugs Pay doctors bills Buy groceries Cover other basic costs YOUR

More information

Excellence Pledge. Strategy #1 Quick!

Excellence Pledge. Strategy #1 Quick! Strategy #1 Quick! Ensure that people s applications for CalFresh food assistance are processed quickly and efficiently in 3-5 days. Applying for CalFresh Benefits Total Number of Applications Percent

More information

The Application for Benefits Eligibility (ABE) An Introduction for MPE Providers & All Kids Application Agents

The Application for Benefits Eligibility (ABE) An Introduction for MPE Providers & All Kids Application Agents The Application for Benefits Eligibility (ABE) An Introduction for MPE Providers & All Kids Application Agents Illinois Department of Healthcare & Family Services Illinois Department of Human Services

More information

2015-2016 Dependent Verification

2015-2016 Dependent Verification V6- DEP FORM 2015-2016 Dependent Verification Your 2015-2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. Northern must compare information

More information

2015-2016 Independent Verification

2015-2016 Independent Verification V6- IND FORM 2015-2016 Independent Verification Your 2015-2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called Aggregate Verification. Northern is required

More information

Brain Injury Association of New Jersey

Brain Injury Association of New Jersey Brain Injury Association of New Jersey 825 Georges Road, 2nd Floor North Brunswick, NJ 08902 Phone: 732-745-0200 Helpline: 1-800-669-4323 Website: www.bianj.org E-mail: info@bianj.org SOURCES OF FUNDING

More information

Health Charity Care Application - Requirements

Health Charity Care Application - Requirements HUTCHINSON FINANCIAL ASSISTANCE PROGRAM Thank you for your interest in Health s Financial Assistance Program. We strive to provide quality, affordable care for all of our patients and are committed to

More information

STUDENT INFORMATION SECTION 1 SECTION 2

STUDENT INFORMATION SECTION 1 SECTION 2 STUDENT INFORMATION If you filed a Federal Tax Return with the IRS, complete SECTION 1 If you filed and amended your taxes, complete SECTION 2 If you did not file taxes and were NOT required to file taxes,

More information

South Carolina Medicaid Program Annual Review Form

South Carolina Medicaid Program Annual Review Form Date: BG #: HH #: Case Name: South Carolina Medicaid Program Annual Review Form This form is used to review your Medicaid coverage. You must return this form to us by: Return to: Healthy Connections, PO

More information

ST. CLAIR HOSPITAL CHARITY CARE FINANCIAL ASSISTANCE PROGRAM QUALIFYING GUIDELINES

ST. CLAIR HOSPITAL CHARITY CARE FINANCIAL ASSISTANCE PROGRAM QUALIFYING GUIDELINES Page 1 of 10 CHARITY CARE FINANCIAL ASSISTANCE PROGRAM QUALIFYING GUIDELINES Charity Care is granted to patients whose credit score is less than the hospital's current threshold of 0. Program guidelines

More information

Personal Pricing Plan Application

Personal Pricing Plan Application **Attention Applicant: Tear this front page off and keep for your records.** Personal Pricing Plan Application About The Personal Pricing Plan is a needs-based scholarship fund made available through the

More information

Closing the Financial Gap for Low-Income Student Parents

Closing the Financial Gap for Low-Income Student Parents Closing the Financial Gap for Low-Income Student Parents The Benefits of Integrated Service Delivery on Community College Campuses A webinar sponsored by IWPR, CLASP and Single Stop USA July 25, 2011,

More information

How To Apply For A Medicaid Or Medicaid Savings Plan In Garyand

How To Apply For A Medicaid Or Medicaid Savings Plan In Garyand Georgia Application for Medicaid & Medicare Savings for Qualified Beneficiaries (QMB - payment of premiums, coinsurance, and deductibles; SLMB - payment of Part B premium; and QI-1 - payment of Part B

More information

Supplement Healthcare Coverage Application

Supplement Healthcare Coverage Application Page 1 Supplement Healthcare Coverage Application About the Healthcare Coverage Application Starting October 1, 2013, you can apply for health coverage through the new Health Insurance Marketplace. Coverage

More information

The Colorado Consumer Health Initiative

The Colorado Consumer Health Initiative Our Members The Colorado Consumer Health Initiative is a unified, statewide organization of consumers and consumer advocates whose goal is quality affordable health care for all Coloradans. Our mission

More information

Is Applying for Disability. the Right Step for Me? 300 S. Adams, Green Bay, WI 54301 920-448-4300 www.adrcofbrowncounty.org

Is Applying for Disability. the Right Step for Me? 300 S. Adams, Green Bay, WI 54301 920-448-4300 www.adrcofbrowncounty.org Is Applying for Disability the Right Step for Me? 300 S. Adams, Green Bay, WI 54301 920-448-4300 www.adrcofbrowncounty.org In This Handout Is applying for disability the right step for me? 2 Considering

More information

FLORIDA YOUR GUIDE TO PUBLIC BENEFITS IN

FLORIDA YOUR GUIDE TO PUBLIC BENEFITS IN WORKING WITH STRUGGLING RESIDENTS 50+ TO WIN BACK OPPORTUNITY INFORMATION TO HELP YOU: Increase your income Save money on prescription drugs Pay doctors bills Buy groceries Cover other basic costs YOUR

More information

Care. and Health in Colorado. Connecting A GUIDE TO SERVICES FOR THE UNINSURED CONSUMER INITIATIVE

Care. and Health in Colorado. Connecting A GUIDE TO SERVICES FOR THE UNINSURED CONSUMER INITIATIVE Connecting Care and Health in Colorado: A GUIDE TO SERVICES FOR THE UNINSURED Connecting Care and Health in Colorado A GUIDE TO SERVICES FOR THE UNINSURED A PUBLICATION FROM THE COLORADO CONSUMER INITIATIVE

More information

SECTION I: Current Michigan Policies on Postsecondary Education for Low-income Parents Receiving Public Assistance

SECTION I: Current Michigan Policies on Postsecondary Education for Low-income Parents Receiving Public Assistance SECTION I: Current Michigan Policies on Postsecondary Education for Low-income Parents Receiving Public Assistance 10 Current Michigan Policies The survey and this report focus on the policies and practices

More information

HUSKY A Parent Transition. Prepared for MAPOC November 13, 2015

HUSKY A Parent Transition. Prepared for MAPOC November 13, 2015 HUSKY A Parent Transition Prepared for MAPOC November 13, 2015 June Special Session, Public Act No. 15-5 Effective August 1, 2015. Reduces the HUSKY A Income Limit for Parents and Caretaker Relatives from

More information

Last Name: First Name: Maiden Name: Street Address or PO Box: City: County: State: Zip Code: High School Graduate

Last Name: First Name: Maiden Name: Street Address or PO Box: City: County: State: Zip Code: High School Graduate Office Use Only Returning Pathways Student Yes No Initial Served : Release Forms Initial Enrollment : Release Form Drop (if applicable): Promo Release Form Income Based: Disclosure Career Pathways Initiative

More information

Medical Financial Assistance

Medical Financial Assistance Medical Financial Assistance YOU MAY BE ELIGIBLE FOR MEDICAL As a nonprofit health plan, Kaiser Permanente strives to help people in need of financial assistance for unforeseen medical expenses. Households

More information

Disaster Recovery: Two Programs for Residents. Peter Rusin August 16, 2014

Disaster Recovery: Two Programs for Residents. Peter Rusin August 16, 2014 Disaster Recovery: Two Programs for Residents Peter Rusin August 16, 2014 The Colorado Energy Office MISSION STATEMENT The CEO s mission is to improve the effective use of all of Colorado's energy resources

More information

How Assisters Can Help Consumers Apply for Coverage through the Marketplace Call Center. July 17, 2015

How Assisters Can Help Consumers Apply for Coverage through the Marketplace Call Center. July 17, 2015 How Assisters Can Help Consumers Apply for Coverage through the Marketplace Call Center July 17, 2015 Agenda Basics about the Marketplace Call Center When to report changes to the Marketplace or other

More information

Your Medicare Matters. Protect It!

Your Medicare Matters. Protect It! Your Medicare Matters. Protect It! Steps to Safeguard Your Medicare brought to you in partnership by Health Insurance Counseling and Advocacy Program (HICAP) California Department of Aging California Senior

More information

Office of Financial Aid 2015 2016 Independent Student Verification Worksheet

Office of Financial Aid 2015 2016 Independent Student Verification Worksheet Office of Financial Aid 2015 2016 Independent Student Verification Worksheet Your 2015 2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The

More information

Financial Benefits for Seniors (9/10/10)

Financial Benefits for Seniors (9/10/10) Financial Benefits for Seniors (9/10/10) Prepared by Broome County Office for Aging Programs are available to seniors that can save you money or increase your income. Eligibility requirements may apply

More information

2015 2016 Household Resources Verification Worksheet. V6-Dependent Student

2015 2016 Household Resources Verification Worksheet. V6-Dependent Student 2015 2016 Household Resources Verification Worksheet V6-Dependent Student Your 2015 2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called Verification. The Financial

More information

Financial Aid and Scholarships Office 2016-17

Financial Aid and Scholarships Office 2016-17 Financial Aid and Scholarships Office 2016-17 Verification Form Dependent Name ID Number (required) Your financial aid application for the 2016-17 academic year has been selected for a process called Verification.

More information

Enrolling Children in Health Coverage Before They Start School: Activities for Early Childhood Programs

Enrolling Children in Health Coverage Before They Start School: Activities for Early Childhood Programs Enrolling Children in Health Coverage Before They Start School: Activities for Early Childhood Programs October Prepared for Covering Kids by Donna Cohen Ross and Meg Booth Center on Budget and Policy

More information

FAMILY-RELATED MEDICAID PROGRAMS FACT SHEET

FAMILY-RELATED MEDICAID PROGRAMS FACT SHEET FAMILY-RELATED MEDICAID PROGRAMS FACT SHEET ACCESS staff in the Department of Children and Families prepared the Family-Related Medicaid Programs Fact Sheet. It is intended to provide general information.

More information

YOUR GUIDE TO PUBLIC BENEFITS IN

YOUR GUIDE TO PUBLIC BENEFITS IN WORKING WITH STRUGGLING RESIDENTS 50+ TO WIN BACK OPPORTUNITY INFORMATION TO HELP YOU: Increase your income Save money on prescription drugs Pay doctors bills Buy groceries Cover other basic costs YOUR

More information

Work While Disabled

Work While Disabled WORKING WITH STRUGGLING RESIDENTS 50+ TO WIN BACK OPPORTUNITY INFORMATION TO HELP YOU: Increase your income Save money on prescription drugs Pay doctors bills Buy groceries Cover other basic costs YOUR

More information

Instructions for AHCCCS Health Insurance Application and Forms. Verification and Documentation Choosing a Health Plan

Instructions for AHCCCS Health Insurance Application and Forms. Verification and Documentation Choosing a Health Plan Instructions for AHCCCS Health Insurance Application and Forms Understanding the AHCCCS Eligibility Process AHCCCS Application Verification and Documentation Choosing a Health Plan Instructions for AHCCCS

More information

Apply faster online at Compass.ga.gov.

Apply faster online at Compass.ga.gov. GEORGIA DEPARTMENT OF HUMAN SERVICES Division of Family and Children Services Application for Health Coverage & Help Paying Costs Form Approved OMB No. 0938-1191 Use this application to see what coverage

More information

Health Reform Community Forum FAQs March 28, 2013

Health Reform Community Forum FAQs March 28, 2013 Differences Between MAGI and Non-MAGI 1) What are the differences between MAGI and Non-MAGI Medi-Cal? MAGI: MAGI is an abbreviation for Modified Adjusted Gross Income and is an income methodology used

More information

Safeguard Your Medicare by Understanding Medicare Advantage Plans. The Medicare Fraud Program. with the Colorado Division of Insurance

Safeguard Your Medicare by Understanding Medicare Advantage Plans. The Medicare Fraud Program. with the Colorado Division of Insurance Safeguard Your Medicare by Understanding Medicare Advantage Plans The Medicare Fraud Program with the Colorado Division of Insurance Dear Medicare Beneficiary: We know how important Medicare is to you

More information

FAMILY-RELATED MEDICAID PROGRAMS FACT SHEET

FAMILY-RELATED MEDICAID PROGRAMS FACT SHEET FAMILY-RELATED MEDICAID PROGRAMS FACT SHEET ACCESS staff in the Department of Children and Families prepared the Family-Related Medicaid Programs Fact Sheet. It is intended to provide general information.

More information

BURIAL ASSISTANCE APPLICATION

BURIAL ASSISTANCE APPLICATION WELFARE ASSISTANCE PROGRAM BURIAL ASSISTANCE APPLICATION Kawerak Burial Assistance (BU) Program is an income based, last resort assistance program. BU offers basic BIA funeral and burial assistance. These

More information

Colorado Works Handbook

Colorado Works Handbook Colorado Works Handbook Advocate for Yourself and Your Family By the All Families Deserve a Chance (AFDC) Coalition All Families Deserve a Chance Coalition August 2013 All Families Deserve a Chance Coalition

More information

MEDICAID. For SSI-related persons. Iowa Department of Human Services. Comm. 28 (Rev.7/10) PRINTED ON RECYCLED PAPER

MEDICAID. For SSI-related persons. Iowa Department of Human Services. Comm. 28 (Rev.7/10) PRINTED ON RECYCLED PAPER MEDICAID For SSI-related persons Comm. 28 (Rev.7/10) PRINTED ON RECYCLED PAPER Iowa Department of Human Services DHS POLICY ON NONDISCRIMINATION No person shall be discriminated against because of race,

More information

Bulletin. Policy Changes to Education and Training Activities in the Minnesota Family Investment Program (MFIP) PURPOSE CONTACT SIGNED

Bulletin. Policy Changes to Education and Training Activities in the Minnesota Family Investment Program (MFIP) PURPOSE CONTACT SIGNED Bulletin NUMBER #14-11-02 DATE OF INTEREST TO County Directors Nation/Tribal Directors Income Maintenance Supervisors and Staff Employment Services Managers and Supervisors Tribal Employment Services Managers

More information

OFFICE OF FAMILY STABILITY LETTER #1 June 3, 2002

OFFICE OF FAMILY STABILITY LETTER #1 June 3, 2002 OFFICE OF FAMILY STABILITY LETTER #1 June 3, 2002 TO: FROM: SUBJECT: Directors, County Departments of Job and Family Services Directors, County Public Children Services Agencies Directors, Child Support

More information

Important! How the Affordable Care Program works

Important! How the Affordable Care Program works Important! How the Affordable Care Program works What is the Affordable Care Program? The Program allows us to offer patients a sliding fee scale, depending on household income. You share the costs of

More information

Understanding Insurance and Our Billing Process

Understanding Insurance and Our Billing Process Understanding Insurance and Our Billing Process Thank you for choosing Cleveland Clinic for your healthcare needs. We appreciate the confidence you have placed in us. This brochure has been prepared to

More information

WOMEN'S OPPORTUNITY SCHOLARSHIP FUND 2016 APPLICATION

WOMEN'S OPPORTUNITY SCHOLARSHIP FUND 2016 APPLICATION PART I WOMEN'S OPPORTUNITY SCHOLARSHIP FUND 2016 APPLICATION NAME: BIRTHDATE: STREET ADDRESS: SOC. SECURITY #: CITY: ZIP: PHONE: Did you apply for this scholarship previously? Yes No If yes, did you receive

More information

Renewal Form. www.upmchealthplan.com/upmcforkids

Renewal Form. www.upmchealthplan.com/upmcforkids Renewal Form www.upmchealthplan.com/upmcforkids There are three easy ways to renew CHIP coverage! To keep CHIP coverage, you can: 1. RENEW ONLINE USING COMPASS: (If you apply online, most of your information

More information

SUPPORT TO GIVE YOU STRENGTH

SUPPORT TO GIVE YOU STRENGTH SUPPORT TO GIVE YOU STRENGTH Annual Campaign Financial Assistance Packet YMCA of Greater St. Louis Financial Assistance at the YMCA of Greater St. Louis Complete attached document and give to your local

More information

**Keep in mind that you do not need to mail this print-out to your local application site.**

**Keep in mind that you do not need to mail this print-out to your local application site.** **Keep in mind that you do not need to mail this print-out to your local application site.** Thank you for using PEAK to apply for benefits! Uni Cycle, your application has been submitted to Boulder on

More information

What is the Medicare Premium Assistance program (MPAP)?

What is the Medicare Premium Assistance program (MPAP)? What is the Medicare Premium Assistance program (MPAP)? MPAP is for certain people eligible for Medicare. It is administered by the Ohio Department of Job and Family Services (ODJFS) as part of the Medicaid

More information

NEW YORK STATE OFFICE OF THE STATE COMPTROLLER

NEW YORK STATE OFFICE OF THE STATE COMPTROLLER NEW YORK STATE OFFICE OF THE STATE COMPTROLLER H. Carl McCall STATE COMPTROLLER DEPARTMENT OF HEALTH MANAGEMENT OF CHILD HEALTH PLUS B 2000-S-28 DIVISION OF MANAGEMENT AUDIT AND STATE FINANCIAL SERVICES

More information

2015 2016 Verification Worksheet Independent Student

2015 2016 Verification Worksheet Independent Student 2015 2016 Verification Worksheet Independent Student Your 2015 2016 Free Application for Federal Student Aid (FAFSA) may be selected for review in a process called verification. The law says that before

More information

YOUR GUIDE TO PUBLIC BENEFITS IN MICHIGAN

YOUR GUIDE TO PUBLIC BENEFITS IN MICHIGAN WORKING WITH STRUGGLING RESIDENTS 50+ TO WIN BACK OPPORTUNITY INFORMATION TO HELP YOU: Increase your income Save money on prescription drugs Pay doctors bills Buy groceries Cover other basic costs YOUR

More information

Application for Health Coverage & Help Paying Costs

Application for Health Coverage & Help Paying Costs Application for Health Coverage & Help Paying Costs Form Approved OMB No. 0938-1191 Use this application to see what coverage choices you qualify for Who can use this application? Affordable private health

More information

YOUR GUIDE TO PUBLIC BENEFITS IN

YOUR GUIDE TO PUBLIC BENEFITS IN WORKING WITH STRUGGLING RESIDENTS 50+ TO WIN BACK OPPORTUNITY INFORMATION TO HELP YOU: Increase your income Save money on prescription drugs Pay doctors bills Buy groceries Cover other basic costs YOUR

More information

Kentucky Children s Health Insurance Program FREE OR LOW COST HEALTH INSURANCE FOR CHILDREN

Kentucky Children s Health Insurance Program FREE OR LOW COST HEALTH INSURANCE FOR CHILDREN Kentucky Children s Health Insurance Program FREE OR LOW COST HEALTH INSURANCE FOR CHILDREN What is KCHIP? FREE OR LOW COST HEALTH INSURANCE FOR CHILDREN Created in 1997 Has served approximately 270,000

More information

Sara Simon Tompkins Staff Attorney National Law Center on Homelessness & Poverty

Sara Simon Tompkins Staff Attorney National Law Center on Homelessness & Poverty FOOD STAMP BASICS Sara Simon Tompkins Staff Attorney National Law Center on Homelessness & Poverty WHAT IS THE FOOD STAMP PROGRAM? The food stamp program is a federal nutrition program that helps people

More information

Housing & Human Services Department Community Acton Agency 400 South Varr Avenue Telephone: (321) 633-1951 Cocoa, Florida 32922 Fax: (321) 633-1958

Housing & Human Services Department Community Acton Agency 400 South Varr Avenue Telephone: (321) 633-1951 Cocoa, Florida 32922 Fax: (321) 633-1958 Housing & Human Services Department Community Acton Agency 400 South Varr Avenue Telephone: (321) 633-1951 Cocoa, Florida 32922 Fax: (321) 633-1958 Thank you for your interest in the Brevard County Low

More information

QUALIFYING STUDENTS FOR SCHOOL MEALS

QUALIFYING STUDENTS FOR SCHOOL MEALS QUALIFYING STUDENTS FOR SCHOOL MEALS Key strategies for increasing federal reimbursements & leveraging additional funding opportunities in Maryland Collecting School Meal Applications Benefit School Budgets

More information

EXPERIMENT IN SELF-RELIANCE, INC. 1550 University Court PO BOX 135 WINSTON-SALEM, NC 27101

EXPERIMENT IN SELF-RELIANCE, INC. 1550 University Court PO BOX 135 WINSTON-SALEM, NC 27101 EXPERIMENT IN SELF-RELIANCE, INC. 1550 University Court PO BOX 135 WINSTON-SALEM, NC 27101 Dear Applicant, We are pleased and excited that you have inquired about the New Century IDA home ownership program.

More information

Supplemental Security Income (SSI)

Supplemental Security Income (SSI) Supplemental Security Income (SSI) Contact Social Security Visit our website Our website, www.socialsecurity.gov, is a valuable resource for information about all of Social Security s programs. At our

More information

DO I QUALIFY? To qualify for assistance from Ribbon Riders, you must meet the following criteria:

DO I QUALIFY? To qualify for assistance from Ribbon Riders, you must meet the following criteria: Ribbon Riders, Inc. PO Box 952283 Lake Mary, FL 32795 407.796.7465 Thank you for contacting Ribbon Riders regarding our Breast Cancer Assistance program. Please review the attached information prior to

More information

Evidence of Insurability

Evidence of Insurability Employee benefits Evidence of Insurability Your group insurance policy may require Evidence of Insurability (EOI) for employees and dependents. EOI is a statement or proof of an employee s or dependent

More information

COLORADO HEALTH CARE COVERAGE

COLORADO HEALTH CARE COVERAGE COLORADO HEALTH CARE COVERAGE Colorado Department of Health Care Policy and Financing administers a variety of Medical Assistance Programs for qualifying persons who live in Colorado and meet eligibility

More information

Enrollment Request Form

Enrollment Request Form Underwritten by UnitedHealthcare Insurance Company Enrollment Request Form Underwritten by UnitedHealthcare Insurance Company SENIOR SUPPLEMENTAL ENROLLMENT FORM Required Information Plan Sponsor Name:

More information

Questions and Answers for Customers Applying for Medicaid in Illinois February, 2014

Questions and Answers for Customers Applying for Medicaid in Illinois February, 2014 Pat Quinn, Governor Julie Hamos, Director 201 South Grand Avenue East Telephone: (217) 782-1200 Springfield, Illinois 62763-0002 TTY: (800) 526-5812 Questions and Answers for Customers Applying for Medicaid

More information

Individual Medicare supplement application

Individual Medicare supplement application Individual Medicare supplement application Please mail your completed application to: Moda Health Plan, Inc., Attn: Medicare Billing & Eligibility, PO Box 40384, Portland, OR 97240-0384 phone 503-265-4762

More information

The Target Efficiency of Online Medicaid/CHIP Enrollment: An Evaluation of Wisconsin s ACCESS Internet Portal

The Target Efficiency of Online Medicaid/CHIP Enrollment: An Evaluation of Wisconsin s ACCESS Internet Portal February 2011 The Target Efficiency of Online Medicaid/CHIP Enrollment: An Evaluation of Wisconsin s ACCESS Internet Portal Lindsey J. Leininger, Donna Friedsam, Kristen Voskuil, Thomas DeLeire University

More information

Qualified Health Plan Certification. Application Instructions

Qualified Health Plan Certification. Application Instructions Qualified Health Plan Certification Application Instructions QHP Certification Submission 1 Contents 2 Background... 3 3 DOI Filings via SERFF... 3 4 SERFF Filing Requirements QHP Certification... 4 4.1

More information

Your Invoice Payment Due Dates...3 Financial Responsibility...3 Payment Options... 3-5 Explanation of Charges... 5-6

Your Invoice Payment Due Dates...3 Financial Responsibility...3 Payment Options... 3-5 Explanation of Charges... 5-6 Table of Contents Your Invoice Payment Due Dates...3 Financial Responsibility...3 Payment Options... 3-5 Explanation of Charges... 5-6 Additional Information Payment Plan...7 Unpaid Balances...7 Credit

More information

V6-Independent Student

V6-Independent Student 2015 2016 Household Resources Verification Worksheet V6-Independent Student Your 2015 2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called Verification. The

More information

Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Transitional Assistance 600 Washington Street

Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Transitional Assistance 600 Washington Street Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Transitional Assistance 600 Washington Street Boston, MA 02111 DEVAL L. PATRICK Governor TIMOTHY P. MURRAY Lieutenant

More information

Central Intake Library Information

Central Intake Library Information Central Intake Library Information Client Intake Page: Consent Consent Expiration First Name Middle Name Last Name Suffix DOB/Code SSN/Code Contact Tab: Last Permanent Address: Street# Street Name Street

More information

2015-2016 REQUEST FOR CONSIDERATION OF SPECIAL CIRCUMSTANCES

2015-2016 REQUEST FOR CONSIDERATION OF SPECIAL CIRCUMSTANCES Financial Aid Office PO Box 359 Sheboygan, WI 53082-0359 Fax: 920-565-1070 INDEPENDENT STUDENT 2015-2016 REQUEST FOR CONSIDERATION OF SPECIAL CIRCUMSTANCES Student Name: Social Security or LC Student ID

More information

2015 2016 Verification Worksheet Independent Student- Group 6

2015 2016 Verification Worksheet Independent Student- Group 6 Student Financial Services 1200 East Colton Avenue, Redlands, CA 92373-0999 Telephone: (909) 748-8047 Email: sfs@redlands.edu Fax: (909) 335-5399 Web site: www.redlands.edu/financialaid.asp 2015 2016 Verification

More information

Back-to-School Outreach and Enrollment: Tactics and Resources for Success

Back-to-School Outreach and Enrollment: Tactics and Resources for Success Back-to-School Outreach and Enrollment: Tactics and Resources for Success Agenda Introductions and Overview Back-to-School Strategies and Resources Grantee Spotlight: Family Healthcare Foundation, Tampa,

More information

Health Benefits for Workers with Disabilities Application

Health Benefits for Workers with Disabilities Application Illinois Department of Public Aid Health Benefits for Workers with Disabilities Application Note: This is NOT an application for cash assistance, food stamps or enrollment in the Medicaid spenddown program.

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 GlobalHealth Medicare Option 1 (HMO) offered by GlobalHealth, Inc. Annual Notice of Changes for 2016 You are currently enrolled as a member of GlobalHealth Medicare Option 1 (HMO). Next year, there will

More information

El Camino College Compton Community Educational Center

El Camino College Compton Community Educational Center El Camino College Compton Community Educational Center ADMISSION AND REGISTRATION PROGRAM REVIEW 2008 El Camino College Compton Community Educational Center Division of Student Affairs Program Review I.

More information

Using Electronic Data to Make Enrollment Easier:

Using Electronic Data to Make Enrollment Easier: Working to ensure that all Americans get enrolled and stay enrolled in our nation s health care system Using Electronic Data to Make Enrollment Easier: A Closer Look at Utah s efind System By Elisabeth

More information

Understanding Insurance and Our Billing Process

Understanding Insurance and Our Billing Process Understanding Insurance and Our Billing Process Thank you for choosing Cleveland Clinic for your healthcare needs. We appreciate the confidence you have placed in us. The purpose of this brochure is to

More information

2015 2016 Independent (V6) Verification Form

2015 2016 Independent (V6) Verification Form 2015 2016 Independent (V6) Verification Form Your 2015 2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law states that before awarding

More information

Arrested? What Happens to Your Benefits If You Go to Jail or Prison?

Arrested? What Happens to Your Benefits If You Go to Jail or Prison? Arrested? What Happens to Your Benefits If You Go to Jail or Prison? A Guide to Federal Rules on SSI, SSDI, Medicaid, Medicare and Veterans Benefits for Adults with Disabilities This guide explains what

More information

Frequently Asked Questions (FAQs)

Frequently Asked Questions (FAQs) Frequently Asked Questions (FAQs) Q: Does everyone need to review their benefit elections? A: Yes, you should. The Open Enrollment period from May 14, 2013 May 28, 2013 is your opportunity to verify, or

More information