... To download the application form for Medicaid in Spanish, please follow this link.
Apply in person. Cover Virginia Additional Person Supplement (Spanish) (PDF) Cover Virginia Application for Health Coverage and Help Paying Costs (PDF) Cover Virginia Application for Health Coverage and Help Paying Costs (Spanish) (PDF) Medicaid Funded Long-term Care Service Authorization (PDF) Notification of …
Complete this application to get help paying for certain coronavirus (COVID-19) testing costs.
There are many effective outreach materials that promote CHIP/Children’s Medicaid. Additional information can also be found in the Understanding Medicaid booklet. You are welcome to use these materials to promote the programs in your own community.If you have the resources and want to customize any of these materials to promote your local CHIP/Children’s Medicaid efforts, please e-mail The following printed materials are available for download. You are welcome to use these materials to promote the programs in your own community. English and Spanish forms can be found under the title "Form to apply for Medicaid for the Elderly and People with Disabilities or Medicare Savings Program" under section "Forms to apply for benefits". If you have the resources and want to customize any of these materials to promote your local CHIP/Children’s Medicaid efforts, please e-mail HHS Communications. There are many effective outreach materials that promote CHIP/Children’s Medicaid.
Also use this form to apply for help paying for health insurance through the Health Insurance Marketplace.If you have more than four people in your home, use these pages to tell us about them.Use this form to apply for assistance with your Medicare premium.Use this application for persons who are planning to live or now live in a nursing facility, group home, or developmental center in Louisiana or who have been offered an opportunity for Waiver or PACE in Louisiana. For additional information about applying for Medicaid, click here to visit Right from the Start Medicaid or to apply for Medicaid please visit. Application for Medicaid Coverage of COVID-19 Uninsured Eligibility Group Testing Costs. Apply for health coverage or renew existing coverageUse this form to apply for or renew coverage for all Louisiana Medicaid programs.
If you get insurance through someone's job or if you can get insurance through a job, get your employer to fill out this form so you can tell us about it.
You can download the resources below or order printed copies of CHIP/Children’s outreach materials. No one should complete this application who is not seeking coverage for COVID-19 tests, or who already has health care benefits and services. Arkansas Medicaid program helps needy individuals pay for basic and necessary medical services living in Arkansas and meeting the program eligibility guidelines. The following logos are designed for use by health plans, community and faith-based organizations, and other contractors involved in promotion of CHIP and Children's Medicaid. Complete this application to get help paying for certain coronavirus (COVID-19) testing costs. All materials are bilingual unless otherwise stated. Texans can dial 2-1-1 (option 6) for information on COVID-19 and local community resources on health care, utilities, food, housing and more. Spanish Vietnamese. Paper applications in English and Spanish can also be … Spanish PDF: Form H1200-S Instructions. No one should complete this application who is not seeking coverage for COVID-19 tests, or who already has health care benefits and services. Before using these logos, please refer to the Download and save the editable PowerPoint flyer to your computer and customize it for your organization.
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