Revision 12-2; Effective June 1, 2012
Occasionally, for purposes of receiving assistance from drug companies or other private entities, a person will request a pre-screening for Medicaid in conjunction with a request for a letter to substantiate the results of the pre-screening.
Form H1035, Pre-Screening Result for Medicaid, is used to notify an interested person of the pre-screening results for Medicaid if:
- the notice is requested by the person;
- the pre-screening is based on a verbal conversation;
- an official determination of eligibility is not conducted; and
- the person does not appear eligible for Medicaid.