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Get Mi Dhs-4574-b 2013
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How to fill out the MI DHS-4574-B online
Filling out the MI DHS-4574-B form is an essential step for individuals seeking eligibility for Medicaid. This guide provides clear and supportive instructions to help users complete the form accurately and efficiently online.
Follow the steps to fill out the MI DHS-4574-B form.
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by filling out the patient’s information. This includes providing the patient's name, phone number of the nursing home, birthdate, and social security number. Ensure that the details are accurate.
- If applicable, enter the spouse's information in the designated fields, including the spouse's name, phone number, address, birthdate, and social security number.
- Proceed to the assets section. Indicate whether anyone in your household has any assets by checking 'Yes' or 'No'. If 'Yes', check all types of assets and complete the provided table with details including the owner(s) and balance of each asset.
- Answer the vehicle section by indicating whether your household owns any vehicles. Check all applicable types and provide the year, make/model, owner(s), and amount owed.
- Respond to questions regarding past transactions, such as selling or giving away assets, or receiving one-time cash payments. Provide information where necessary.
- Complete the affidavit section by signing the form. If signed by a mark, ensure two witnesses sign as well.
- Finally, review the completed form for accuracy. Once confirmed, save your changes, download, print, or share the completed form as required.
Complete your documents online now to ensure a smooth application process.
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For those seeking Medicaid coverage in Michigan in 2025, the income limit involves calculating personal income against the federal poverty level. The specific threshold can depend on factors like family size. When pursuing Medicaid benefits, using the MI DHS-4574-B form allows applicants to accurately assess their eligibility and streamline the application process.
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