Some items have an asterisk (*) next to them, indicating they are mandatory. You must complete these items before you can continue to the next page.
Your User PIN must be correctly entered to electronically sign the Redetermination/Change Report/Simplified Report. If you have forgotten your User PIN, click Save & Exit to save your Redetermination/Change Report/Simplified Report and return to the MyAccount page to access your User PIN.
Click the Submit button to save and submit the online Redetermination/Change Report/Simplified Report.
Click the Print button to print this page for your reference.
Click the Previous button to view the previous page.
For Redeterminations
This page displays your rights and responsibilities when redetermining or re-enrolling in programs and requests your electronic signature before submitting your redetermination/re-enrollment.
Click the Save & Exit button to exit the online Redetermination and save your progress on your Redetermination. The Redetermination is saved as Incomplete.