South Carolina Request for an Individuals Health Information

State:
Multi-State
Control #:
US-3577
Format:
Word; 
Rich Text
Instant download

Description

This form is used by an individual to request access to his or her protected health information. The individual's rights regarding this access are also acknowledged by the individual.

How to fill out Request For An Individuals Health Information?

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FAQ

To qualify, your monthly income cannot be higher than $1,010 for an individual or $1,355 for a married couple. Your resource limits are $7,280 for one person and $10,930 for a married couple. A Qualifying Individual (QI) policy helps pay your Medicare Part B premium.

Healthy Connections is South Carolina's Medicaid program. It is a medical assistance program that helps pay for some or all medical bills for many people who cannot afford medical care.

As of 2019, the FPL for a family of three is $21,330 in the 48 contiguous states plus the District of Columbia. In Alaska, this number rises to $26,600. In Hawaii, the FPL for a family of three is $24,540. For an individual, the contiguous U.S. has determined the FPL to be $12,490.

MEDICAID APPLICATION DOCUMENTSDRIVERS LICENSE, PHOTO ID CARD, OR PASSPORT.SOCIAL SECURITY CARD FOR APPLICANT, (and spouse if living)RED, WHITE AND BLUE MEDICARE CARD.HEALTH INSURANCE CARDS, PREMIUM AMOUNT STATEMENT.BIRTH CERTIFICATES FOR APPLICANT (Naturalization papers for immigrants) MARRIAGE CERTIFICATE if married.

Income eligibility: The income limit is $1,063 a month if single and $1,437 a month if married. Asset limits: The asset limit is $7,860 if single and $11,800 if married. These income and asset limits are the same as for the QMB program, meaning QMB enrollees receive full Medicaid benefits in South Carolina.

Income Limit: Monthly Net Income Limit may not exceed $1,526 per month. The individual's resources must not exceed $2,000.

Federal Poverty Level thresholds to qualify for Medicaid The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. For example, in 2022 it is $13,590 for a single adult person, $27,750 for a family of four and $46,630 for a family of eight.

The general Medicaid eligibility rule is that a person can't have more than $2,000 in countable assets. If you are trying to become eligible for Medicaid to pay long-term care costs, you may need to spend down your assets or use other strategies to qualify.

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South Carolina Request for an Individuals Health Information