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  • Utah State Medicaid Form 114mc

Get Utah State Medicaid Form 114mc

DWS-ESD/WDD 114MC Rev. 11/2012 State of Utah Department of Workforce Services myCase AUTHORIZATION TO RELEASE INFORMATION TO A THIRD PARTY Name: Case Number: I authorize the Department of Workforce.

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Contact Utah Medicaid For member concerns or complaints, contact the Division of Integrated Healthcare Constituent Services Representative at (801) 538-6417 or 1-877-291-5583 or email medicaidmemberfeedback@utah.gov.

The expansion extends Medicaid eligibility to Utah adults whose annual income is up to 138% of the federal poverty level ($17,608 for an individual or $36,156 for a family of four). The federal government covers 90% of the costs for these services, with the state covering the remaining 10%.

UTAH MEDICAID INFORMATION In the Salt Lake City area, call (801) 538-6155. In Utah, Idaho, Wyoming, Colorado, New Mexico, Arizona, and Nevada, call toll-free 1-800-662-9651. From other states, call 1-801-538-6155.

The only method to apply for Utah Unemployment benefits, enter direct deposit information, or make any changes is through this official state website or by calling the Claims Assistance and Re-Employment Team at 801-526-4400.

1-888-222-2542 (Monday – Friday, 8a. m. – 5 p.m.) Please call 1-866-435-7414 (Monday – Friday, 8 a.m. – 5:00 p.m.) Or, leave a message and we will return your call.

Welcome to Healthy U Medicaid Health Insurance Medicaid is a state/federal program of health insurance coverage for Utah's vulnerable populations. Medicaid pays for medical services for the following: Low-income pregnant women. Children.

Provider Re-enrollment If you are a provider that has been terminated please contact Provider Enrollment at (801) 538-6155, or toll-free 1-800-662-9651 (option 3 then 4) to request re-enrollment.

Please call the Medicaid Member Information Line at 1-844-238-3091 with questions or concerns. Starting June 26, 2022, we are changing our log in system to MyBenefits. In order to access MyBenefits website, you will need to create an account at UtahID if you do not already have a UtahID account.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232