Get Access For Infants And Mothers Application - Aim - State Of California - Aim Ca

This guide provides users with clear and supportive instructions on how to complete the Access for Infants and Mothers Application online. Whether you are experienced with forms or new to the process, these steps will help you navigate the application smoothly.

Follow the steps to fill out the application effectively.

1. Press the ‘Get Form’ button to access the application and open it in the editor.
2. Begin by providing your information in Section 1. Fill out fields such as your last name, first name, and birthdate. If any questions do not apply, write ‘N/A’. Remember, not having a Social Security Number does not disqualify you.
3. Provide your complete address, including the street address (no P.O. Box), unit/apt number, phone number, and county. Be sure to include your expected delivery date and the number of babies expected.
4. Indicate if anyone in your household smokes by selecting YES or NO. This will not affect your application eligibility.
5. If your billing and mailing address is different from the information provided, fill out that information in the designated section.
6. Move to Section 2, where you will answer questions about health insurance coverage. Respond to whether your insurance covers your pregnancy and provide details about maternity deductibles.
7. Choose your preferred health plan and medical group by referencing the related sections in the application.
8. In Section 3, provide information about your family size and household income. Complete both Part A (for the father of the unborn child) and Part B (for members of your federal tax household) as appropriate.
9. Indicate your current income situation, including employment status and how often you receive income. Detailed responses to questions about self-employment and other income are required.
10. In Section 4, read and agree to the declarations regarding eligibility and program regulations.
11. Proceed to Section 5, where you will provide authorizations for the release of your medical information and understand your rights and obligations under the program.
12. Finally, review your application for accuracy, sign the form, and indicate the date. Save your changes and either download, print, or share the completed form.

Complete your Access for Infants and Mothers Application online today for timely assistance.