Get Mn Dhs-3418-eng 2013

This guide provides clear, step-by-step instructions for completing the MN DHS-3418-ENG form online. By following these instructions, users can ensure their information is accurately submitted for renewals in Minnesota's Health Care Programs.

Follow the steps to complete the form online.

1. Click the 'Get Form' button to obtain the MN DHS-3418-ENG form and open it in the online editor.
2. Read the Notice of Privacy Practices and Rights and Responsibilities located on pages A through C of the form. Tear them off and keep them for your records.
3. Fill in all required personal information in Section 1, including your name, date of birth, and contact details.
4. Complete Section 2 by listing anyone who lives with you, including their relationship to you and their Social Security number if applicable.
5. In Section 3, indicate if you are applying for someone not currently receiving coverage, providing their details where necessary.
6. Provide necessary employment and income details in Section 6 and 7 if applicable. Ensure to include gross income and any other relevant information about employment.
7. Complete Sections 8 through 14, detailing any additional income sources, assets, and property ownership as instructed.
8. Go to the Signature Page. Review the statements, and sign and date the form to acknowledge your understanding and agreement.
9. Attach the required proofs and documents, as listed in the form instructions, to support your information.
10. Save the changes in the online editor and download or print the completed form for submission to your county or MinnesotaCare state office.
11. Submit the form along with the requisite attachments, ensuring it is sent back before the due date to avoid any lapse in your health care coverage.

Complete and submit your MN DHS-3418-ENG form online today to ensure the continued support of your health care coverage.