Application for Presumptive Eligibility for Medicaid

State:
Multi-State
Control #:
US-0538BG
Format:
PDF
Instant download

Description

Use this form to find out quickly if you qualify for presumptive eligibility for Medicaid. Presumptive eligibility offers you and your family immediate access to health care while you apply for regular Medicaid or other health coverage.
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Application for Presumptive Eligibility for Medicaid