Get Wkr003 Fillable Form

The Wkr003 Fillable Form is essential for reviewing your Medicaid coverage. This comprehensive guide will help you complete each section of the form accurately and efficiently.

Follow the steps to complete your Wkr003 Fillable Form online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by entering personal information about the beneficiary at the top of the form. This includes last name, first name, middle initial, mailing address, city, county, state, zip code, street address (if different), and telephone numbers.
3. If an authorized representative is filling out the application, provide their name, phone number, address, and relationship to the applicant.
4. Proceed to list yourself, your spouse, and any dependent children. Fill in each individual's name, Social Security number, date of birth, and marital status.
5. Indicate if your spouse or dependent child works. If they do, input their gross pay before taxes and deductions. You may need to send proof of income for the past four weeks.
6. List any other income received by any family member, specifying the source and amount. Remember to include proof of all listed income.
7. Answer whether there are adults in the home who are not employed and provide details about their last employment.
8. If the applicant or spouse has closed any bank accounts or sold/given resources in the past year, provide necessary details about these actions.
9. For assets or resources, indicate whether anyone has them and provide proof for each as required.
10. Finally, confirm if there are any changes in private health insurance and ensure all required documentation is attached.
11. After completing the form, save your changes, download a copy, print it, or share as necessary.

Complete your Wkr003 Fillable Form online today to ensure your Medicaid coverage continues without interruption.