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MEDICAID NOTICE CAO RETURN ADDRESS CSLD Notice ID: CO RECORD DIST CAT GG PS WORKER: TELEPHONE: DATE: NOT: OPT: TYPE: IF YOU DO NOT UNDERSTAND OUR DECISION OR HAVE ANY QUESTIONS, PLEASE CONTACT YOUR.

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A copy of applicant's Social Security card. Health Insurance Information: Copies of Medical Insurance card(s) including Medicare and any supplemental health care and/or prescription drug coverage for applicant. Invoices for these policies demonstrating the premium costs and frequency of payment.

In PA, the spend down amount is calculated for a 6-month period. Once one has met their spend down, they will be income-eligible for Medicaid services for the remainder of the period. The MNO-MA asset limits are $2,400 for an individual and $3,200 for a couple. There is no additional asset disregard.

Dental, vision, and hearing. Hospitalization and emergency care. Mental health and substance abuse. Rehabilitation and therapies (mental and physical)

The PA EBT ACCESS card is an industry-standard plastic card with a magnetic strip. It provides recipients access to Cash Assistance, SNAP and Medical Assistance benefits. Recipients access their SNAP benefits electronically through point-of-sale (POS) terminals in authorized food stores.

If a non-married person applying for benefits has more than $2,742 of gross monthly income, then the resource limit for countable (non-exempt) resources is $2,400. If the applicant has gross income which is $2,742 or less, then the person's resource limit is $8,000.

Identity — Identity can be verified by a driver's license, state identification card or another piece of identification. Social Security Number (SSN) — A SSN must be provided for each person applying for Medical Assistance. County Assistance Office staff will help you apply for an SSN for anyone who does not have one.

Typically it takes up to 30 days to get a decision once a Medical Assistance (MA) application is submitted. However, if the applicant is experiencing a medical emergency, the County Assistance Office (CAO) can speed up the proceeding of the application.

What is a PA 162 form used for? This is an application for Medical Assistance benefits. If you need help translating it, please contact your county assistance office, CAO.

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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