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Get TN TC0131 2013

Use this application? TN residents who need care in a long term care facility, even if they can be served safely in their home. What if you don’t need long term services and supports but you want to apply for TennCare? Go to www.healthcare.gov to apply. Is someone helping you fill out these pages? Yes No If yes, is it OK for us to talk to that person about you or your case? Yes No If yes, then tell us: Their name _______________________________________________________________ Their phone numb.

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