109 APPLICATION PROCESS SR 03-04, 01/03 (AAM-A)

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Any individual has the right to apply for assistance and to have an eligibility decision made. Individuals have the right to file an application on the same day they contact the District Office. Advise individuals that they may file the application before an interview is conducted.

Application at the District Office for all programs is made on Form 800H, HEIGHTS Application Form, generated at the conclusion of the Client Registration (CR) process. Form 800H contains an official Request for Assistance (RFA) and the official Filing Date of the application.

Exceptions:

• Form 800Q, Assisted Application For Help With Medicare Costs For Medicare Beneficiaries, is a mail-in application used only by New Hampshire Housing Authority (NHHA) residents, or by individuals who have been assisted with the application process by a trained volunteer counselor from Health Insurance Counseling, Education, and Assistance Services (HICEAS), to apply for the Qualified Medicare Beneficiary (QMB), Special Low Income Medicare Beneficiary (SLMB), Special Low Income Medicare Beneficiary at 135% of federal poverty income guidelines (SLMB135) *, and Qualified Working and Disabled Individual (QDWI) programs.

• An individual may request and receive paper Form 800, Application, by contacting any District Office. If the individual contacts the District Office by telephone or mail, and does not want to come to the office to file an application on the same day, mail a Form 800 on the same day the request is received.

• Individuals applying for assistance at hospitals may complete and submit paper Form 800, Application.

Following CR, most applicants are required to participate in a detailed interactive Application Entry (AE) eligibility interview with a Case Technician.