Name of the Organization : Utah Department of Health
Type of Facility : Apply For Medicaid
State : Utah
Country : United States of America
Website : https://medicaid.utah.gov/apply-medicaid
Application Form : https://www.statusin.org/uploads/24212-Application.pdf
Apply For Medicaid :
** You may apply in person, by mail, or online.
** When we receive your application, the Department of Workforce Services (DWS) will contact you by mail or phone.
Related : Utah Division of Occupational & Professional Licensing Apply Online License Renewal : www.statusin.org/24218.html
** DWS may need more information to determine if you are eligible for a medical program.
** DWS will also tell you what proofs you need to provide, like a birth certificate.
How to Apply for Medical Benefits :
Note :
** If you apply online, you do not need to complete a paper application.
By Mail :
Download a Medical Application.
Mail completed application to:
Department of Workforce Services
PO Box 143245
Salt Lake City, UT 84114-3245
By Fax :
Download a Medical Application.
Fax completed application to:
Department of Workforce Services
Fax: 801-526-9505
Toll-free Fax: 1-888-522-9505
In Person :
** Download a Medical Application.
** You may apply at any Department of Workforce Services (DWS) office.
** Please click here and type in your zip code to find an office near you.
** For answers to your questions on how to apply, please call the Department of Workforce Services (DWS)
** Salt Lake County (801) 526-0950 or Toll-free 1-866-435-7414.
Medical Applications :
** If you want to apply for medical assistance only – Medical Only Application
** If you want to apply for Nursing Home Medicaid or Long Term Care Medicaid – Long Term Care Addendum
** If you want to apply for medical assistance, as well as other programs (Food Stamps, Child Care and/or Financial assistance) – Multi-Program Application
** If you fill out and turn in this multi-program application, you DO NOT need to fill out a Medical Only Application – Multi-Program Application
Note :
** If you are not able to print the above applications, you can request to have one mailed to you by calling: Salt Lake County (801) 526-0950 or Toll-free 1-866-435-7414.
You Have the Right to :
** Apply or re-apply any time you wish for any medical program. Some programs are only available during open enrollment periods.
** If you need help, someone will help you apply.
** Receive a notice that we have either approved or denied your application and the reasons for the decision.
** For medical assistance, we have 30 days to process your application. We have 90 days, if you claim to be disabled, unless you need more time.
** If you need more time, you need to request for it before the end of the 30 or 90 days period.
** Be notified explaining why we reduce, stop or hold your assistance. In most instances, we must mail the notice 10 days before we do this.
Do the following things if you do not agree with decisions made regarding your case :
A. Talk to your worker. Make sure you are not misunderstanding each other.
B. Talk to your worker’s supervisor.
C. Talk to Constituent Services: 1-801-526-4390 or call toll-free 1-800-331-4341
D. Request a Fair Hearing within 90 days of the decision; 10 days to get benefits while the hearing is held.
E. If you were denied disability status, you may also ask for a reconsideration as part of the fair hearing.
F. If SSA denied your disability, you would have to go through their appeal process.
Responsibilities :
** Children enrolled in Medicaid are automatically enrolled in the Utah Statewide Immunization Information System (USIIS).
** If you do not want your children enrolled in this system, you must call the USIIS HelpLine at 1-801-538-6872 or the Immunization Hotline at 1-800-275-0659.
** You must cooperate in any review of your case by Quality Control, Recovery Services, and the Bureau of Eligibility Policy.
** You must also cooperate in providing information about any other sources of medical payments and obtaining medical support.
** If you feel you could be harmed by giving this information, you can request a ‘good cause’ claim.
** Your worker can explain this procedure.