Eligibility Online Manual

M407 Defining Client Responsibilities

Purpose: This section will provide information about client responsibilities when applying for Medicaid benefits.

Current Policy Effective Date: January 1, 2014

Date Last Reviewed: April 1, 2015

Previous Policy: January 1, 2010


1. Applicants Must Complete Application

Applicants must complete an application for medical benefits.

2. Applicants Must Submit Application

Applications must be submitted to the Wyoming Department of Health Customer Service Center or the Medicaid Long Term Care Unit, depending on the type of case.

3. Applicants Must Cooperate With Eligibility Determination Process

Applicants must cooperate with the eligibility determination process by doing one or more of the following:

    • Participate in an interview when applying for the Long Term Care programs.

    • Provide verification of citizenship and identity or immigration status, when required.

    • Provide verification of eligibility factors, when required.

    • Provide information essential to make an eligibility decision.

    • Provide verification of income, when required

    • Provide verification of date of birth, when required.

    • Provide SSN or proof of an SSN application, as specified in Section M603, when required.

4. Applicants/Clients Must Notify State Of Changes Affecting Eligibility

Changes impacting eligibility must be reported within ten (10) calendar days.

Reference Section M1601 for additional information on reporting changes.

5. Clients Must Provide Information Within Fifteen (15) Days

Clients must provide information, documentation or verification within fifteen (15) calendar days of request.

6. Applicants May Declare Medical Expense Information

Applicants requesting retroactive Medicaid benefits, may declare on the application that medical expenses were incurred.

7. Applicants/Clients Must Provide Health Insurance Information

8. Applicants/Clients May Need To Provide Child Support Information

Applicants/Clients must provide information to assist in establishing paternity and obtaining medical support and payment, when required by the program.


Defining Requirement: 42 CFR 435.905 – 910

Clarifying Information:

Worker Responsibilities: