S20AB, X0006 - Provisional Coverage Excess Income FHP Ineligible Due to Excess Income Chose Spenddown Equivalent Insurance Federal Employee or Over 65 Adults Only Read more about S20AB, X0006 - Provisional Coverage Excess Income FHP Ineligible Due to Excess Income Chose Spenddown Equivalent Insurance Federal Employee or Over 65 Adults Only
S20AA, X0001 - Accept Excess Income Monthly Spenddown Read more about S20AA, X0001 - Accept Excess Income Monthly Spenddown
H3W, Y0102 - Authorize Medicaid Coverage Immediate Referral from NYSoH cover letter Read more about H3W, Y0102 - Authorize Medicaid Coverage Immediate Referral from NYSoH cover letter
H2W, Y0136 - Renewal Letter Individual Transferred from New York State of Health (NYSoH) FORM QUESTIONS Read more about H2W, Y0136 - Renewal Letter Individual Transferred from New York State of Health (NYSoH) FORM QUESTIONS
C66, U0175 - FHP to MA Incarcerated Individual Released (Upstate) Read more about C66, U0175 - FHP to MA Incarcerated Individual Released (Upstate)
C56, U0176 - Reopening: Case Closed as Incarcerated in Error (Upstate) Read more about C56, U0176 - Reopening: Case Closed as Incarcerated in Error (Upstate)
C50,Y0001 - Accept All Covered Care and Services Read more about C50,Y0001 - Accept All Covered Care and Services
C43, Y0026 - Accept FPBP Waived Right To MA FHP Read more about C43, Y0026 - Accept FPBP Waived Right To MA FHP