Get Ri Kb-dhs1&2 2012-2025

Filling out the RI KB-DHS1&2 form is essential for a child with a disability to apply for Medical Assistance through the Katie Beckett Coverage Group. This guide will walk you through each step of completing the form online, ensuring a smooth application process.

Follow the steps to complete your application accurately.

1. Press the ‘Get Form’ button to download the form and open it in an online editor. This will allow you to fill out the application digitally.
2. Indicate whether this is a new application or an annual redetermination by checking the appropriate box at the top of the form.
3. Fill in the applicant child’s last name, first name, and middle name in the designated fields.
4. Provide the address of the applicant child, including the street number, street name, apartment number (if applicable), city, state, and zip code.
5. Enter the applicant child’s Social Security number and birthdate in the specified formats.
6. Select the applicant child's sex by checking either 'Male' or 'Female'.
7. Complete the contact information for the parent, guardian, or adult representative. Add their name, relationship to the applicant child, home and daytime phone numbers, and email address if available.
8. If an interpreter is needed, indicate this by checking 'Yes' or 'No', and specify the required language.
9. Confirm if the applicant child is a Rhode Island resident by checking 'Yes' or 'No', and provide an explanation if applicable.
10. Answer questions regarding the applicant child's citizenship status, residency, and disability diagnosis. Complete the required fields accordingly.
11. Document any financial resources, including cash and bank accounts. Accurately provide the amounts and account details.
12. Indicate any additional relevant information such as medical expenses, loans, or legal claims that pertain to the applicant child.
13. Review the Rights and Responsibilities section carefully to ensure understanding of the terms.
14. Sign and date the application at the bottom, ensuring that all necessary parties have signed if more than one parent or guardian is involved.
15. Once the form is fully completed, save your changes. You may then download, print, or share the form as needed.

Complete your RI KB-DHS1&2 application online today to ensure your child receives the necessary support.