Get Tn Tc0131 2018-2026

This guide provides comprehensive instructions on how to complete the TN TC0131 form online. The process is designed to be user-friendly, catering to individuals who may not have extensive legal experience.

Follow the steps to successfully complete the TN TC0131 form online.

1. Click the ‘Get Form’ button to access the TN TC0131 form and open it in the document editor.
2. Begin by providing your personal information in the first section. Fill in your full name, home address (not a P.O. Box), mailing address if different, and your phone number. Confirm whether you intend to be a Tennessee resident.
3. In the next section, indicate if you are receiving Medicaid benefits from another state. If yes, provide the state name and whether you wish to have TennCare assist you with stopping those benefits.
4. Continue with questions about your needs for services, indicating if you are applying for nursing home care, home and community-based services, or hospice care.
5. List all individuals living in your household. Include their full names, dates of birth, Social Security numbers if they want coverage, and their relationship to you.
6. Answer questions related to citizenship status, spouse or parent living arrangements, and any current care in a nursing facility.
7. Provide details about any other health insurance policies you or any household member may have. Include the insurance company name, policy number, and coverage details.
8. Document all sources of income for you and anyone living with you. Include employment earnings, Social Security, unemployment amounts, and other forms of income.
9. Complete information regarding any child care or care for a disabled adult you pay for, including the provider details and costs.
10. In the asset section, list all items you own, including properties, vehicles, and bank accounts, providing their values and any amounts owed.
11. If applicable, fill out additional questions regarding past financial transactions, including any sales or transfers of assets within the last five years.
12. Select your health plan preference if applying for CHOICES or related services. If you are only applying for Medicare cost assistance, this step is not necessary.
13. Review all provided information for accuracy and completeness before signing the form at the designated signature section.
14. Once completed, save your changes, download a copy for your records, and be prepared to either print the form or submit it electronically if applicable.

Complete your TN TC0131 application online today to ensure you receive the necessary services and support.