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Form 820 Request to Determine Presumptive Eligibility (Pe) - New Hampshire
What Is DFA Form 820?
This is a legal form that was released by the New Hampshire Department of Health and Human Services - Division of Family Assistance - a government authority operating within New Hampshire. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DFA Form 820?A: DFA Form 820 is the Request to Determine Presumptive Eligibility form.
Q: What is Presumptive Eligibility (PE)?A: Presumptive Eligibility (PE) is a temporary period of eligibility for certain healthcare programs.
Q: Who can use DFA Form 820?A: Individuals in New Hampshire who meet the eligibility criteria can use DFA Form 820 to request Presumptive Eligibility.
Q: What is the purpose of DFA Form 820?A: The purpose of DFA Form 820 is to determine if an individual qualifies for Presumptive Eligibility for healthcare programs.
Q: What healthcare programs can Presumptive Eligibility cover?A: Presumptive Eligibility can cover programs such as Medicaid or other state-funded healthcare programs.
Q: Is Presumptive Eligibility a permanent eligibility status?A: No, Presumptive Eligibility is a temporary period of eligibility and needs to be renewed.
Q: What documents are required to submit DFA Form 820?A: The specific documents required may vary, but generally, you will need to provide proof of identity, income, and residency.
Q: What happens after I submit DFA Form 820?A: After submitting DFA Form 820, the Department will review your application and determine if you are eligible for Presumptive Eligibility.
Form Details:
- Released on April 1, 2015;
- The latest edition provided by the New Hampshire Department of Health and Human Services - Division of Family Assistance;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of DFA Form 820 by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Health and Human Services - Division of Family Assistance.
