Get New Choice Waiver Utah
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How to fill out the New Choice Waiver Utah online
The New Choice Waiver Program offers Medicaid recipients a choice to receive long-term care services in home and community-based settings. This guide provides a comprehensive overview of how to complete the New Choice Waiver Referral Form, ensuring users have the necessary information to fill it out accurately.
Follow the steps to complete the New Choice Waiver Referral Form online
- Click ‘Get Form’ button to obtain the New Choice Waiver Referral Form and open it in a suitable editor.
- Begin filling out the 'Applicant Information' section. Enter the applicant's full name, date of birth, social security number, and Medicaid ID. Also, include the admission date and application date.
- Proceed to the 'Current Location' section. Fill in the facility name, address, city, state, zip code, and provide the current location's phone number. If applicable, add the cell phone and fax number.
- Next, complete the 'Referent Information' section by entering the referent's full name, address, city, state, zip code, and all relevant phone numbers (work, home, and cell) along with their relationship to the applicant.
- In the 'Contact Information' section, choose to either use the applicant's information or the referent's information. Specify the contact person's name, address, city, state, zip, and phone numbers.
- Indicate how you learned about the waiver in the designated field.
- Review all entered information for accuracy. Once confirmed, you can save the changes, download, print, or share the completed Referral Form as needed.
Take the next step in securing care by completing your New Choice Waiver Referral Form online today.
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The highest income level to qualify for Medicaid in Utah depends on your household size and the specific program requirements. As these limits can change over time, it’s important to stay informed by checking with the Utah Medicaid office. Utilizing resources like the New Choice Waiver Utah can provide clarity on the income guidelines and help ensure you meet eligibility requirements.