Get Support Plan Addendum

This guide provides clear instructions for completing the SUPPORT PLAN ADDENDUM online. By following these steps, users can efficiently provide the required information and support while ensuring compliance with necessary regulations.

Follow the steps to complete the SUPPORT PLAN ADDENDUM online.

1. Click the ‘Get Form’ button to access the SUPPORT PLAN ADDENDUM. This will allow you to open the document in an online editor for easy completion.
2. Review the estate recovery information provided at the beginning of the form. It's important to understand the implications of Medicaid benefits and estate recovery before proceeding.
3. Proceed to the Home and Community Based (HCBS) Waiver Services section. Depending on the individual's needs, select and certify which waiver programs (HCBS, SCL, MP, Model II, ABI, ABI/LTC) are relevant.
4. In the Freedom of Choice of Provider section, sign and date to acknowledge your understanding that you may choose from any qualified Medicaid provider for services.
5. Complete the Member Information section by providing the name, Medicaid Member ID, address, city, zip code, and phone number of the individual receiving services.
6. Finally, have the person assisting with the completion of the form sign and provide their title, agency or facility name, and contact information in the designated area.
7. Once all sections of the form are filled out, review for accuracy. You may then save your changes, download the completed document, print it, or share it as necessary.

Start completing your SUPPORT PLAN ADDENDUM online today for a smoother and more efficient process.