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The document is a CFEEC Evaluation Request Form for mainstream plan members seeking non-covered long-term care (LTC) benefits. It includes sections for managed care plan information, member details, acknowledgment of medical information release, physician authorization, and managed long-term care plan representative submission. The form outlines the requirements for transferring to a Managed Long Term Care Plan (MLTC) and the necessary medical services needed for eligibility.

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What is CFEEC?

The Conflict Free Evaluation and Enrollment Center (CFEEC) decides if you can join a Managed Long Term Care (MLTC) plan. The CFEEC is a program of New York State Medicaid. The CFEEC sends a nurse to your home to evaluate whether you need long term care services such as home care.

Is Freedom Care an MLTC?

Freedom Care is a managed long-term care (MLTC) plan that offers a range of services and support for individuals who require long-term care. It is designed to help individuals remain in their homes and communities while receiving the necessary care and assistance they need.

What is form 1020 in Texas Health?

Form H1020-A is a Texas Health form designed to assist in gathering proof of age, relationship, and income statements. This document outlines the various types of acceptable proof to ensure eligibility for services. Use this form to provide the necessary evidence requested by your advisor.

What is EPC UCF?

The primary function of the Evaluation and Proficiency Center (EPC) is to provide students with a secure, distraction-free environment for taking assessments in courses that utilize the EPC.