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Get MD MCHP Renewal Application

Applying For MCHP Is Not Eligible For Free Medical Care Would you (the parent or guardian of the applicant) be willing to pay $46.00 - $58.00 premium payment each month to cover all children in the household for health insurance coverage through MCHP Premium? YES NO 7A. Does Anyone Applying For MCHP Have Employer-Based Health Insurance? YES NO If Yes, answer the following: Name of Policy Holder ______________________________________________________ Name of Person(s) covered ________________.

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