BFA Form 820 Request to Determine Presumptive Eligibility (Pe) - New Hampshire

BFA Form 820 Request to Determine Presumptive Eligibility (Pe) - New Hampshire

What Is BFA Form 820?

This is a legal form that was released by the New Hampshire Department of Health and Human Services - Bureau 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 BFA Form 820?A: BFA Form 820 is a Request to Determine Presumptive Eligibility (PE) form.

Q: What is Presumptive Eligibility?A: Presumptive Eligibility is a temporary eligibility for Medicaid coverage while the full eligibility determination is processed.

Q: Who can use BFA Form 820?A: The BFA Form 820 can be used by individuals who are seeking temporary Medicaid coverage in New Hampshire.

Q: What is the purpose of BFA Form 820?A: The purpose of BFA Form 820 is to request a determination of presumptive eligibility for Medicaid coverage in New Hampshire.

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Form Details:

  • Released on February 1, 2020;
  • The latest edition provided by the New Hampshire Department of Health and Human Services - Bureau 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 BFA Form 820 by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Health and Human Services - Bureau of Family Assistance.

Download BFA Form 820 Request to Determine Presumptive Eligibility (Pe) - New Hampshire

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