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Get IN ICHIA-015 2006-2024

Cant Information.p65 ICHIA-015 Rev.1/17/06 Applicant Information Your Guide to Health Care Coverage HOW DO I APPLY FOR A POLICY? 1 2 3 4 5 WHAT IS ICHIA? How to Contact Us WHAT BENEFITS ARE OFFERED BY ICHIA? How the PPO Works Covered Benefits How Premium Rates are Determined It’s easy to apply. Step 1: You must appliy to Medicaid within 60 days prior to sending an application to ICHIA. Step 2: Provide a fully executed Medicaid Application Verification Form. Step 3: Select the Plan righ.

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