Get Nc Dma: 3b, Pace - Nc Department Of Health And Human Services - Ncdhhs

Filling out the NC DMA: 3B, PACE form is an essential step for accessing the Program of All-Inclusive Care for the Elderly in North Carolina. This guide offers clear, step-by-step instructions to help users successfully complete the form online.

Follow the steps to fill out the NC DMA: 3B, PACE form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Review the eligibility criteria outlined in the form. Ensure that you or the individual filling the form meets the financial and federal eligibility requirements for the PACE program.
3. Complete the personal information section. This includes details such as the applicant’s name, date of birth, and contact information.
4. Fill out the sections regarding health insurance status, including Medicare and Medicaid details, if applicable.
5. Complete the section regarding enrollment agreement, ensuring to provide any required signatures or verifications as indicated.
6. Review the description of services covered under the PACE program, confirming that you understand the included services.
7. After completing all necessary fields, double-check the information for accuracy and completeness.
8. Once verified, save the document. You can then choose to download, print, or share the completed form as required.

Start completing your form online today to access PACE benefits.