Problem Forms : Mainstreaming Medical Care : Programs : The Arc of New Jersey

Medicaid Eligibility Problem Form

Family members and staff may use this form when a person with an intellectual and developmental disability is having difficulty obtaining Medicaid.
Medicaid Problem Form

Family members and staff may use this form if an individual is currently enrolled in a Medicaid HMO and is having difficulty obtaining a medical, dental, or behavioral health service that should be covered by the HMO. This form can also be used if the HMO has reduced the approved number of hours of a service (e.g., personal care assistant services or private duty nursing).