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Get Dphhs Hmk Form

Ed to apply for children s health coverage through the Healthy Montana Kids (HMK) Plan. Individuals age 19 and older do not qualify for HMK coverage. APPLICATION INSTRUCTIONS Please complete the entire application in black or blue ink. Please print your answers. If you need assistance completing this application, call the HMK helpline at 1-877-543-7669 or contact your county Office of Public Assistance. If more space is needed to complete your answers, attach an additional sheet with appropria.

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