Medicaid Provider Training
Below are the documents mentioned in the Medicaid Training Document
- W-1E application (Application for Benefits)
- W-1LTSS application (Spanish) (Long-term Care/Waiver Application)
- W-1ER application (Eligibility Re-determination)
- W-265 (Report of Admission or Discharge Rated Housing Facility/Residential Care Home)
- W-298 (Authorization for Disclosure of Information)
- W-1685 (Medical Insurance Information)
- W-849 (LLR form)
- W-300T19 (Title XIX Disability Determination - Medical Report)
- W-300MED (Medicaid for the Employed Disabled - Medical Report)
- W-303 (Client Supplement for Medical Information)
- W-303a (Permission to Share Medical Information)
- Medicaid Coverage Groups and Actions
- Fact Sheet - DDS Maintaining Medicaid Eligibility equals Waiver Eligibility
- MyAccount Guide
- MyAccount: Online Renewal Guide
Below are some additional documentation for your convenience.
- W1-QMB Application (Application for Medicare Savings Programs (QMB, SLMB, ALMB))
- QMBR Application (Medicare Savings Programs Re-determination)
- DDS Funeral Funds for DDS Individuals
- W-1J (page 13 of the W-1LTSS App, Long-term Care/Waiver Application)
- W-1LTSS Section N (pages 11 and 12 of the W-1LTSS App)
- W-35 (for employers) Certificate for Disclosure of Gross Wages, Salary or Commission Paid
- COLA 2023 Rated Housing Letter
- Rent subsidy and DSS 2018 (currently still in effect)
- Spend Down Process
- Spend Down Approved Items
- Personal Needs Allowance and Disregard Breakdown
- ABLE Act 1-30-23