Medicaid/Waiver Eligibility

The Medicaid/Waiver Eligibility Process is the charge of a State of Utah staff member.

See Support Coordination Standards posted on the Division of Services for People with Disabilities website:

http://dspd.utah.gov/pdf/Support_Coordinator_Contract_Standards.pdf

to find the expectation of the Division of Services for People with Disabilities.

 

The following describes the process:

The Medicaid/Waiver Eligibility process can be started at any time after the consumer is in "Waiting List" status and the Level of Care has been complete. The waiver enrollment process (known as the Form 927) can be found on the Main Consumer menu as shown here:

 

The process consists of a number of interactions between the caseworker, the consumer, the Bureau of Eligibility Services (BES/DWS) and the Department of Health (DOH), as shown in this next diagram:

 

 

Enrollment

 

Clicking on the Medicaid Eligibility consumer menu item opens up the Waiver Eligibility screen.

 

Clicking opens up this next screen:

 

The Waiver Request tab is completed with the did or will option and the begin date. If you are not ready to send Form 927 to BES, then simply click and you can return to this screen at a later time. If you are ready to proceed with sending it, then click and send the completed form.

Note: This Waiver Request tab process is not considered to be complete until the is clicked.  The Form 927 with Part 1 completed is scanned and e-mailed to the Bureau of Eligibility Services in the Department of Workforce Services.

When Form 927 is returned from Medicaid, click on the Waiver Response tab as next shown:

 

 

Step 1: Select Eligible

 

Step 2: Select HCB Medicaid in the Eligibility Type drop down list.

 

Step 3: Enter the Effective Date and the remainder of the data as contained on the form (i.e. Client ID, Client Name, Spend Down).

 

Step 4: Click .

Note: Once has been clicked, then the person is automatically enrolled in the waiver that has been requested and their financial eligibility is SM, BM or PM/PN respectively.