Medicaid Application for Justice Involved Individuals
This application is to be used for Justice Involved Individuals to request Medicaid determination of eligibility. Individuals must meet specific program requirements to be considered for this program, listed on the application. Both the Application and Application Addendum must be submitted to the email listed on the addendum, under instructions.
Attention Carceral
Facilities: You are encouraged
to take the Division of Welfare and Supportive Services (DWSS) Learning & Development - Medicaid Application and Addendum for Justice Involved Individuals training on
HOW TO complete the abbreviated Medicaid application. The YouTube link is below or on the YouTube website: https://youtu.be/5S1WCz4fBdQ OR NVeLearn: https://nvelearn.nv.gov/moodle/course/search.php?search=justice+involved
Change Report Form 2584 - Effective communication among the facility, the inmate, and
the parent or guardian is essential. It is crucial to provide daily updates on
the release dates of upcoming inmates. Any changes regarding release dates, income, household
composition, address, and similar matters must be reported by the 5th of the
following month. However, reporting this information sooner will expedite the
case review process.
Facility staff and/or the parent or guardian can use form 2584 to report these changes. It is vital that once an incarcerated youth is
released, both the inmate and the authorized representative report the current
mailing address. This is necessary for issuing a new Medicaid card, a new
Notice of Decision letter, and any other important healthcare information.
If you require additional
assistance, please contact the Division of Welfare and Supportive Services (DWSS)
at justicemed@dwss.nv.gov, with
the subject line: Justice Involved Assistance Request.
APPLICATIONS and FORMS