Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability

2.3.1.3 Authorization to Obtain Information

A valid Authorization to Obtain Financial Information from the Asset Verification Service (AVS) (DHS-7823) is a condition of eligibility and must be on file for people with an MA-ABD basis of eligibility who are subject to an asset limit. A valid authorization means one that is signed, in effect, and in the electronic or paper case file for the applicant or enrollee and any person whose assets are used to determine the applicant or enrollee’s eligibility.

Before submitting a request for financial information through the AVS, the county, tribal or state servicing agency must verify a valid authorization is on file.

The Authorization to Obtain Financial Information form(s) must be maintained in the enrollee's case file, even when it is no longer valid.

Authorization Requirements

The Authorization to Obtain Financial Information form must be signed by:

The person (applicant or enrolee) or their authorized representative
- If the person has a legal guardian, the guardian must sign for the person, unless they appoint an authorized representative.
- If the person has passed away, the personal representative of the estate must sign for the person.
The person’s spouse, sponsor, sponsor’s spouse , or their legal representative, if their assets are used to determine the person’s eligibility. A sponsor is someone who signed an Affidavit of Support (USCIS I-864) as a condition of the person’s, or his or her spouse’s, entry to the country.

A separate authorization is needed for each spouse when both spouses are applying or eligible for MA-ABD and have an asset limit.

Each person may sign the same form or a separate form; however, no other authorization or release form may be used in place of the (DHS-7823) form.

Duration of the Authorization

A signed authorization form remains in effect until one of the following occurs:

The MA application is withdrawn or denied.
The enrollee’s MA is closed. However, an enrollee’s authorization remains in effect if eligibility is reinstated due to agency error or delay in processing.
The enrollee’s MA basis of eligibility is no longer MA-ABD with an asset limit.
The person or their authorized representative withdraws the authorization in writing.
The authorized representative who signed the AVS authorization on behalf of another person is no longer the authorized representative.
The person dies, even when it is signed by another person on their behalf.

New Authorization Required

A new authorization form is required as a condition of eligibility for people who have an MA-ABD basis of eligibility and are subject to an asset limit and before a request can be submitted through the AVS when:

A previously completed authorization is no longer in effect for any of the reasons listed under the Duration of the Authorization section above.
No record of a valid authorization is in the electronic or paper case file.
An enrollee gets married or has a change in eligibility that causes the spouse’s assets to be considered in the eligibility determination when they previously were not considered.
- Only the spouse’s signature is required if the enrollee’s authorization form otherwise remains in effect.
- The spouse does not need to sign a new form if they already signed the authorization form which remains in effect.

The authorization was received and there was not an active MHCP program to make it valid or it was not received with or after an application for a MHCP.

Legal Citations

United States Code, title 42, section 1396w