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Michigan Department of Community Health Document Number MEDICAL TRANSPORTATION STATEMENT Only ONE medical provider and ONE transporter per form. See Page 2 for Instructions Copy Distribution PA 431 and Non-Discrimination Information. SECTION I - DHS Specialist Completes DHS Specialist Name Authorized Rate Standard Special Patient/ Beneficiary Name DHS Case No. CO MA-TOA Level of Care Code Beneficiary ID No. Patient/Bene. PDT Bank ID No. Amount D.

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The term "public assistance" includes a wide variety of assistance programs you may receive, including cash assistance, food assistance, child care and medical services.

The Michigan Department of Health and Human Services (MDHHS) is a principal department of state of Michigan, headquartered in Lansing, that provides public assistance, child and family welfare services, and oversees health policy and management, including mental health and substance abuse services.

The Homeowner Assistance Fund was established under section 3206 of the American Rescue Plan Act of 2021 (the ARP) to mitigate hardships associated with the coronavirus pandemic by providing funds to prevent homeowner mortgage delinquencies, defaults, foreclosure, loss of utilities or home energy services and ...

A Medicare program called “Extra Help” can help people with limited income and assets pay for their Medicare drug costs. To be eligible, you must join a Medicare drug plan and meet certain income and asset limits. You may be automatically eligible if any of these are true: You have full Medicaid coverage.

Contact Provider Inquiry at 1-800-292-2550 to verify eligibility.

Answer general questions you may have about Medicaid benefits. Enroll you in the Medicaid Health Plan you choose. For more information, call Michigan ENROLLS at 1-888-367-6557.

The total MDHHS/PATH program cost of repairs may not exceed $900 including any repairs done in the previous 12 months. Clients may contribute any amount over $900 prior to MDHHS payment. roadworthy including new tires, headlamps, batteries, etc.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232