Form 1004D Presumptive Eligibility (Pe) Cfi / Hcbc Application Cover Sheet for Medicaid - New Hampshire

What Is Form 1004D?

This is a legal form that was released by the New Hampshire Department of Health and Human Services - Division of Family Assistance - a government authority operating within New Hampshire. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 1004D?
A: Form 1004D is the Presumptive Eligibility (PE) CFI/HCBC Application Cover Sheet for Medicaid in New Hampshire.

Q: What is Presumptive Eligibility (PE)?
A: Presumptive Eligibility (PE) is a temporary coverage available to individuals who are potentially eligible for Medicaid while their full application is being processed.

Q: What is CFI?
A: CFI stands for Community Financial Institution, which is a designated entity that helps determine presumptive eligibility for Medicaid.

Q: What is HCBC?
A: HCBC stands for Health Coverage Bridge Certificate, which provides temporary coverage during the presumptive eligibility period.

Q: What is the purpose of the application cover sheet?
A: The application cover sheet is used to apply for Presumptive Eligibility (PE) for Medicaid in New Hampshire.

Q: Who is eligible for Presumptive Eligibility (PE)?
A: Individuals who meet the basic eligibility criteria for Medicaid and are in need of immediate medical assistance may be eligible for Presumptive Eligibility (PE).

Q: Is Presumptive Eligibility (PE) permanent coverage?
A: No, Presumptive Eligibility (PE) is temporary coverage while the full Medicaid application is being processed.

Q: What happens after the Presumptive Eligibility (PE) period ends?
A: Once the Presumptive Eligibility (PE) period ends, individuals will need to complete a full Medicaid application for long-term coverage.