The CAO must review the information provided in an application of each individual who applies or contacts the CAO before or at the application interview. This is called the screening interview, and it may be conducted face to face, by telephone or by mail. 55 Pa. Code § 125.24(b)
Generally, the CAO determines which is the right category of medical benefits for an individual and explains to the applicant what the requirements are for that category.
At the screening interview, the CAO must take the following actions, if appropriate:
Explain what questions on the application form must be answered.
Help the individual fill out the application form.
Review the information on the application form to make sure that it correctly reflects the individual’s current situation and needs.
Important: If no income or limited income is reported, the CAO must ask for more information in order to find out how the individual has been able to get by.
Determine if the individual needed MA benefits during the three months before he or she applied.
Determine what information needs to be proven and explain how the applicant can show that the information is true.
Explain that in order to make eligibility determinations, the CAO needs the cooperation of all applicants when it comes to giving information and proving that it is true.
Let the individual know about the eligibility conditions that must be met and what information is needed to meet those conditions. Tell the individual how to obtain proof that is acceptable.
Explain what the requirements are for GA related eligibility requirements, and give the applicant the forms needed to prove that he or she is eligible. (See Chapter 305, Category.)
If applicable, have the individual fill out the Criminal History Inquiry Form. (See Appendix C for procedures.) 62 P.S. 481.1
Tell the individual that they must apply for potential resources.
Give the individual brochures or other appropriate information about the program.
Schedule an application interview if necessary so that the CAO can determine if the individual is eligible within 30 days of the application date. For the Healthy Beginnings program, there needs to be a determination of eligibility within 45 days of the application date if presumptive eligibility was approved.
NOTE: The 30-day period may be extended to 45 days if the individual is given notice in writing for why there has been a delay.
Complete two copies of the appointment notice (PA 253) listing what type of proof is needed. Give the original to the applicant, and attach the copy to the application form.
Exception: When the CAO determines that an individual is ineligible during the screening interview, the CAO must deny the application unless the individual asks for an application interview. (See Section 304.53, Denying an Application When an Applicant Is Not Eligible.)
Let the applicant know of other available services, including, but not limited to, the following: 55 Pa. Code § 121.3(a)(iii)
Updated February 14, 2012, Replacing June 16, 2008