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For more information call 1-800-843-6154 for persons using TTY 1-800-447-6404. HFS 2378H R-10-06 IL478-1685 Instructions 1 INSTRUCTIONS Read the application carefully and follow all instructions.

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How to fill out the 2378h Form online

This guide provides a clear and supportive approach to completing the 2378h Form online for medical benefits. Designed for individuals applying for medical assistance, this step-by-step guide will help you understand the necessary sections and required information.

Follow the steps to fill out the 2378h Form successfully.

  1. Press the ‘Get Form’ button to access the 2378h Form, which you will open in your digital editor.
  2. Read the application instructions carefully. Ensure that you complete all required pages, paying attention to the specific needs of your situation.
  3. Fill in the applicant's personal information, including name, contact details, and any necessary supplementary information for each household member.
  4. Provide details about any required supporting documents, such as proof of income, citizenship, or additional forms if applicable (Forms A through H) as specified.
  5. Review your answers carefully, ensuring that all information is accurate and complete. If you encounter any questions or need assistance, consider reaching out to a local Department of Human Services office.
  6. Once you have filled out the form, sign and date where required, confirming the truthfulness of the information provided.
  7. Finally, save your changes, and prepare to submit the form along with any required documents via mail to your local DHS office.

Complete your 2378h Form online today for access to essential medical benefits.

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1-800-842-1461. To use the automated system, you must have the individual's Medicaid Recipient Identification Number (RIN) and the date of service for which you need eligibility information. If you do not know the individual's RIN, you need the individual's name, birthdate and SSN and must talk with hotline staff.

Medicaid is a jointly funded state and Federal government program that pays for medical assistance services.

HealthChoice Illinois is the statewide Medicaid managed care program.

The Department operates three distinct care coordination programs within the broader Illinois Medicaid Managed Care program: HealthChoice Illinois (HCI), YouthCare, and the Medicare Medicaid Alignment Initiative (MMAI).

MEDICAID APPLICATION DOCUMENTS DRIVERS LICENSE, PHOTO ID CARD, OR PASSPORT. SOCIAL SECURITY CARD FOR APPLICANT (and spouse if living) RED, WHITE, AND BLUE MEDICARE CARD. HEALTH INSURANCE CARDS, PREMIUM AMOUNT STATEMENT.

The Department operates three distinct care coordination programs within the broader Illinois Medicaid Managed Care program: HealthChoice Illinois (HCI), YouthCare, and the Medicare Medicaid Alignment Initiative (MMAI).

1-800-842-1461. To use the automated system, you must have the individual's Medicaid Recipient Identification Number (RIN) and the date of service for which you need eligibility information. If you do not know the individual's RIN, you need the individual's name, birthdate and SSN and must talk with hotline staff.

The Illinois Department of Healthcare and Family Services (HFS) is committed to improving the health of Illinois' families by providing access to quality healthcare.

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© Copyright 1997-2026
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
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232