115 JOINT APPLICATIONS (MAM-A)

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DFA Form 800, Application for Assistance

DFA Form 800, Application for Assistance, along with DFA Form 800 Insert, is used by financial assistance, medical assistance, child care and Food Stamp applicants. However, if a current recipient applies for Food Stamp benefits or another program of assistance during the in-office redetermination interview for the other program, Form 800HR, HEIGHTS-generated Application for Assistance, may be used rather than a separate DFA Form 800/DFA Form Insert.

Determine the programs of assistance for which the individual wants to apply and conduct one interview for all programs. MAGI-related medical assistance groups are not required to participate in an interview.

Exception: If necessary to meet the Food Stamp expedited processing time frames, finish the interview for the remaining programs at a later date.

When the same eligibility factors are involved in each program, verification provided to meet the verification requirements for one program of assistance is used to meet the verification requirements for all other programs of assistance requested. For example, if each program of assistance the individual has requested requires verification of citizenship and the individual provides a Birth Certificate, the Birth Certificate satisfies citizenship verification requirements for all the programs of assistance requested. However, each program has different eligibility policies which cannot be used for programs outside of the program for which the policy is written. For example, the Food Stamp Program allows shelter deductions. The FANF program does not have these deductions. Therefore, shelter and utility costs may be subtracted from income that is considered available to the household only when determining Food Stamp eligibility and benefit allotment, and not when determining FANF eligibility and benefit allotment.

DFA Form 800MA, Application for Health Coverage & Help Paying Costs

DFA Form 800MA, Application for Health Coverage & Help Paying Costs, is used by Medical Assistance applicants only. DFA Form 800MA collects eligibility information specific to *Medical Assistance, Qualified Health Plan (QHPs), and Insurance affordability programs, including Advance payments of the premium tax credit (APTCs) and Cost-sharing reductions (CSRs). *

DFA Form 800 *must be completed in addition to DFA Form 800MA when the individual would also like to apply for other forms of assistance, such as cash, Food Stamp benefits, and child care assistance*. Although an interview is not required for the MAGI-related medical assistance groups, an interview is required for the non-MAGI-related medical assistance groups and services, and requests for cash, Food Stamps, and child care assistance.

Do not delay the eligibility decision in one program when all the required verification is provided for that program but not for the other(s).

Application processing time frames must be met for each program of assistance for which the individual applied. If individuals are denied for one program while a decision is pending for other programs, they are not required to file a new application. Use the original application to determine eligibility for the remaining programs.

References: He-W 601.01(n) & (p), He-W 601.03(a), He-W 602.03, RSA 167:8,I, 7 CFR 273.2(b)(3), 42 CFR 435.907, 42 CFR 435.911, 42 CFR 435.1200(e), 45 CFR 206:10(a)(1) & (b)(1)-(3)