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Application for 1915(c) HUBS Waiver: NY.4125. R05.00 Apr 01, 2017Page 1 of 125Application for a 1915© Home and CommunityBased Services WaiverPURPOSE OF THE HUBS WAIVER PROGRAM The Medicaid Home and
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Start by gathering all the necessary documents and information required for the application, such as personal identification, medical records, and financial information.
02
Research and familiarize yourself with the specific eligibility criteria and guidelines for the 1915c program.
03
Complete the application form accurately and thoroughly, making sure to provide all the required information and supporting documentation.
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Review and double-check the completed application before submitting it to ensure accuracy and completeness.
05
Submit the application to the appropriate agency or organization responsible for processing 1915c applications.
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Follow up on the application status periodically to ensure that it is being processed in a timely manner.
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If additional information or documentation is requested during the application process, promptly provide the requested items.
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Once the application is approved, carefully review the terms and conditions of the 1915c program and sign any necessary agreements or contracts.
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Be prepared to attend any required meetings, assessments, or interviews as part of the application process.
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If the application is denied, understand the reasons for denial and consider seeking assistance from a legal or advocacy organization to navigate the appeals process if applicable.

Who needs application for a 1915c?

01
People who require specialized, home and community-based services to meet their long-term care needs may need to fill out an application for a 1915c. This program is designed to assist individuals who have physical or mental disabilities, chronic illnesses, or other conditions that require ongoing support and assistance with daily activities. The specific eligibility criteria for 1915c programs may vary by state or region, so it is important for individuals to research and understand the requirements for their particular area.
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An application for a 1915c is a request for a specific Medicaid waiver to provide home and community-based services.
State Medicaid agencies are required to file applications for a 1915c.
The application for a 1915c must be completed according to the state guidelines and requirements, including providing detailed information about the requested waiver and the services to be provided.
The purpose of the application for a 1915c is to request approval for a Medicaid waiver to offer specific home and community-based services.
The application for a 1915c must include detailed information about the requested waiver, the services to be provided, the population to be served, and how the services will meet the needs of individuals in the community.
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