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  • Pa 162-rm 2008

Get Pa 162-rm 2008-2025

A THE FOLLOWING PERSONS ARE INCLUDED FOR THE MONTH(S) SHOWN LINE NO. B MONTH & YEAR NAME MONTH MONTH MONTH & YEAR & YEAR & YEAR RETROACTIVE MEDICAL ASSISTANCE LINE NO. MONTH MONTH MONTH MONTH & YEAR & YEAR & YEAR & YEAR NAME MONTH & YEAR MONTH & YEAR MONTH & YEAR MONTH & YEAR CATEGORY CONTROL DIGIT RESOURCES RESOURCE LIMITATION GROSS MONTHLY INCOME NET MONTHLY INCOME INCURRED MEDICAL EXPENSES ELIGIBLE FOR RETROACTIVE MEDICAL ASSISTANCE ELIGIBLE WITH A PATIENT PAY LIABILITY OF.

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Children aged 18 and under. Pregnant women. Parents and caretakers of children under 21. Adults ages 19-64 with incomes at or below 133 percent of the Federal Income Poverty Guidelines (FPIG)

Identity — Identity can be verified by a driver's license, state identification card or another piece of identification. Social Security Number (SSN) — A SSN must be provided for each person applying for Medical Assistance. County Assistance Office staff will help you apply for an SSN for anyone who does not have one.

How long will it take for my application to be processed? It should not take longer than 45 days if all necessary documentation needed to determine your eligibility for the Medical Assistance program is given to the county assistance office. What must I verify?

In approximately half of the states, ABD Medicaid's income limit is $914 / month for a single applicant and $1,371 for a couple. In the remaining states, the income limit is generally $1,215 / month for a single applicant and $1,643 / month for a couple.

What is a PA 162 form used for? This is an application for Medical Assistance benefits. If you need help translating it, please contact your county assistance office, CAO.

The MNO-MA asset limits are $2,400 for an individual and $3,200 for a couple. There is no additional asset disregard. 2) Asset Spend Down – Seniors who have assets over Medicaid's limit can still become asset-eligible by spending down extra assets on non-countable ones.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232