TN 62 (04-20)

SI DEN01120.203 Mailing Addresses for Medicaid Eligibility Decisions on Trusts

Once a decision on the trust has been made and is properly coded on the SSIRD, send a copy of the trust document to the appropriate State Medicaid agency as indicated below:

1634 States

Colorado

Department of Health Care Policy & Financing
1570 Grant St
Denver, CO 80203
ATTN: Trust Unit

or fax to: 303-866-3552

or email as an attachment to: Medicaid.Trusts@state.co.us

South Dakota

Department of Social Services
Division of Economic Assistance
700 Governors Drive
Pierre, SD 57501
ATTN: Medicaid Eligibility Program Administrator

Montana

Department of Public Health & Human Services
PO Box 202925
Helena, MT 59620
ATTN: Trust Reviewer

Wyoming

Department of Health
Office of Health Care Financing
6101 Yellowstone Rd., Suite 210
Cheyenne, WY 82002
ATTN: Trust Reviewer

209(b) and SSI Criteria States

North Dakota

Department of Human Services
Legal Advisory Unit
600 E Boulevard Ave Dept. 325
Bismarck, ND 58505-0250
ATTN: Trust Reviewer

Utah

Department of Workforce Services
Centralized Imaging Unit
P O Box 143245
Salt Lake City, UT 84114

or fax to: (801) 526-9500 or
1-877-313-4717

If you are in the Denver Region and have any questions regarding where to send trusts contact ||DEN CPS.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0501120203DEN
SI DEN01120.203 - Mailing Addresses for Medicaid Eligibility Decisions on Trusts - 04/27/2020
Batch run: 04/27/2020
Rev:04/27/2020