Get 470 2927 Form

The 470 2927 Form is essential for individuals and families seeking health services in Iowa, including medical assistance, WIC, and maternal and child health services. This guide provides clear and detailed instructions for filling out the form online, ensuring that all necessary information is accurately included.

Follow the steps to successfully complete the 470 2927 Form online

1. Click the ‘Get Form’ button to access the 470 2927 Form and open it in the editing interface.
2. Start by filling out your household information. Include your first, middle, and last name, address, phone number, and check the programs you are applying for, such as Medical Assistance, WIC, or Maternal and Child Health Services.
3. List all individuals living in your home, providing their names, Social Security numbers, dates of birth, and citizenship status. Indicate whether you are applying for each individual and any medical services they have received in the past three months.
4. Document your income sources. Include the name of the person receiving income, employer or income source, amount before taxes, and how often it is paid. Ensure to note if this income is expected to continue.
5. Provide details about your resources. List the type of resources, their value, and where they are located. Include information about cash on hand, bank accounts, and any other relevant assets.
6. Complete the Social Security Number section. Fill in the SSNs for all persons listed on the application to comply with federal requirements for Medical Assistance.
7. Review your application for accuracy and completeness. Sign and date the form at the bottom to certify that the information provided is true to the best of your knowledge.
8. Save your changes to the form and choose to download, print, or share your application as needed. Follow any additional instructions provided for submitting the form to the appropriate Department of Human Services office.

Start filling out the 470 2927 Form online today to access essential health services.