Form DOH-5247KO Medicaid Authorized Representative Designation / Change Request - New York (Korean)

This is a legal form that was released by the New York State Department of Health - a government authority operating within New York.

The document is provided in Korean. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the DOH-5247KO form?
A: The DOH-5247KO form is a Medicaid Authorized Representative Designation/Change Request form in Korean language for residents of New York.

Q: Who can use the DOH-5247KO form?
A: The DOH-5247KO form can be used by individuals in New York who want to designate or change their Medicaid authorized representative.

Q: What is the purpose of the DOH-5247KO form?
A: The purpose of the DOH-5247KO form is to designate or change a Medicaid authorized representative, who can act on behalf of an individual for Medicaid related matters.

Q: Is the DOH-5247KO form specific to Korean language?
A: Yes, the DOH-5247KO form is specifically in Korean language.

Q: Do I need to fill out the DOH-5247KO form if I already have a Medicaid authorized representative?
A: No, you only need to fill out the DOH-5247KO form if you want to designate a new representative or change your existing Medicaid authorized representative.