Get Ultc 100.2 - Ascend Management Innovations

The ULTC 100.2 form is essential for assessing an individual’s eligibility for long-term care services. This guide will provide clear, step-by-step instructions to help you fill out the form accurately and efficiently online.

Follow the steps to complete the ULTC 100.2 form online.

1. Press the ‘Get Form’ button to access the ULTC 100.2 form and open it in your preferred online editor.
2. Complete the 'Current Living Situation' section by selecting the appropriate living arrangement from the options provided, such as 'Alone' or 'With Spouse/Others'.
3. Fill in the 'Applicant Information' section by entering the applicant's state ID, name, address, county ID, date of birth, marital status, and social security number.
4. Describe the 'Presenting Problems and Diagnoses' by providing relevant comments that detail any health issues or concerns the applicant may face.
5. Identify 'Areas of Concern' by marking the appropriate boxes for assistance required in daily activities like bathing, dressing, and mobility.
6. In the 'Potential Community Based Long Term Care Programs' section, select any applicable programs the individual may qualify for, noting all relevant options.
7. Provide 'Financial Information' by detailing both the client's and spouse's income sources, gross monthly income, and any assets that may affect eligibility.
8. Complete the 'Insurance Information' part by filling in the client's insurance details, along with any other medical provider information as needed.
9. Ensure that you fill out all relevant 'Medical Information' as provided by a medical professional to facilitate the assessment process.
10. Finally, review all entered information for accuracy before saving, downloading, printing, or sharing the completed form as needed.

Start filling out the ULTC 100.2 form online today to ensure timely access to necessary long-term care services.