Reason for Changes
In order to comply with federal requirements outlined in the Deficit Reduction Act of 2005, the following changes are being made to the JFS 07200, "Request for Cash, Food Stamp, and Medical Assistance". The new Medicaid citizenship requirement in rule 5101:1-38-02 of the Administrative Code will be effective September 25, 2006. Utilization of the revised JFS 07200 should be used beginning on or after October 1, 2006.
Description of the Revisions to the "Request for Cash, Food Stamp, and Medical Assistance," JFS 07200
Application Coversheet, Page Two, "What type of verification do I need?"
The first bullet immediately underneath the heading has been revised to read "If you are not a U.S. citizen and are only applying for alien emergency medical assistance, you do not have to verify your citizenship status or immigration status, or provide a social security number." Adding "or immigration status" will help to clarify that the individual does not have to provide INS documents for alien emergency medical assistance.
The second line item of the verification chart has been revised to read "Permanent Resident Card ("green card") or other INS documentation if not a U.S. citizen" to use terminology commonly understood by applicants.
Since proof of citizenship status is required for all individuals applying for any category of Medicaid and Cash Assistance Programs, "Proof of U.S. citizenship if a U.S. citizen" has been added as the third line item of the verification needed for Medical Assistance and Cash Assistance Programs.
Annuities have been included on the seventh line item, "Proof of current value of stocks/bonds, certificates of deposit, life insurance, trusts, annuities. "
Page Two of the Application, Section Six: "Tell us about the people in your home"
The question "Are you married?" has been added under the chart requesting information about household members.
Page Three of the Application, Section Seven: "Tell us about your finances"
In the second question, annuities have been added as an example of resources that an assistance group may possess.
Page Four of the Application, Section Nine: "Signature of person who completed this application"
A statement has been added as the second bullet that attests that all annuities and other similar financial devices in which the assistance group has any interest have been reported by the applicant or the authorized representative.
Miscellaneous
The Spanish and Somali versions of the JFS 07200 will be issued under separate cover at a later date.
INSTRUCTIONS: FOOD STAMPS:
| LOCATION | REMOVE AND FILE AS OBSOLETE | INSERT/REPLACEMENT |
|---|
| Appendix 101-A |
JFS 07200,
Request for Cash, Food Stamp,
and Medical Assistance
(Rev. 05/2005)
|
JFS 07200,
Request for Cash, Food Stamp,
and Medical Assistance
(Rev. 10/2006)
|
Appendix 35
Record of Changes to Handbook
| N/A |
Update with the number and
date of this transmittal
|
INSTRUCTIONS: CASH ASSISTANCE:
| LOCATION | REMOVE AND FILE AS OBSOLETE | INSERT/REPLACEMENT |
|---|
CAM APPENDIX
JFS FORMS | | |
| |
Outline of Contents
(Effective August 1, 2006)
|
Outline of Contents
(Effective October 1, 2006)
|
| |
JFS 07200 Request for Cash,
Food Stamp, and Medical Assistance
(Rev. 05/01/05)
|
JFS 07200 Request for Cash,
Food Stamp, and Medical Assistance
(Rev. 10/2006)
|
INSTRUCTIONS: MEDICAL ELIGIBILITY MANUAL:
| LOCATION | REMOVE AND FILE AS OBSOLETE | INSERT/REPLACEMENT |
|---|
MEM APPENDIX
JFS FORMS |
JFS 07200 Request for Cash,
Food Stamp, and Medical Assistance
(Rev. 05/01/05)
|
JFS 07200 Request for Cash,
Medical and Food Stamp Assistance
(Rev. 10/2006)
|