Asset Validation Form to keep Medical Assistance (MA)

December 4, 2019

If you’re 21 or older and get Medical Assistance (MA) for people who are blind or have a disability, or a Medicare Savings Program (MSP), you must sign an asset validation form to keep getting MA or MSP. If you don’t sign the form, your MA or MSP will close. Your Home and Community Based Services (HCBS) waiver and home care services will also close if your MA closes.

What do I need to do?

  • Wait to get the authorization form in the mail. You will get an Authorization to Obtain Information from the Account Validation Service (AVS), DHS-7823 (PDF) sometime between now and March, 2020.
  • When you get the form, read the cover letter included with the authorization form that explains why you are getting the form and what you need to do.
  • Fill in and sign the form. Give it to your county/tribal worker by the due date listed on the cover letter.
  • If you will not be able to return the form by the due date, contact your county or tribal worker. They can give you more time to complete the form.

You can go to DHS Account Validation Service (AVS) to find out more.

Families, providers, lead agencies, advocacy organizations, and other supports: Work with the people you know/serve who are on MA (over 21 and with a disability) or MSP to help make sure they complete and return this form.