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Family-Related Medical Assistance Application Form Approved DCF No. CF-ES 2370, Dec 2013 65A-1.205, F.A.C. things to know Use this application to see what coverage choices you qualify for Free or.

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How to fill out the Medicaid Application - Healthy Florida online

Filling out the Medicaid Application - Healthy Florida can be straightforward with the right guidance. This guide provides a clear and comprehensive approach to ensure that users have the support they need throughout the online application process.

Follow the steps to effectively complete your application.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by providing information about yourself, including your full name, date of birth, and contact details. Make sure to include your Social Security number, as it is essential for processing your application.
  3. Indicate your household's income by providing details of your employment status, income sources, and any deductions that apply. Accurate reporting of your financial situation is crucial for determining your eligibility for Medicaid coverage.
  4. List all family members who need to be included in the application. Be sure to provide pertinent information for each individual, such as their relationship to you and their income, if applicable.
  5. Answer the health coverage questions regarding current insurance or Medicaid coverage and any recent changes in health insurance status.
  6. Read and sign the application, confirming the accuracy of the information provided. Ensure that you understand your rights and responsibilities under the Medicaid program.
  7. Finally, save your changes and submit the completed application by email or by mailing it to the provided address, ensuring that you keep a copy for your records.

Complete your Medicaid Application - Healthy Florida online today for a streamlined experience and more accessible healthcare options.

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You can use the number on your Medicaid approval letter until you get your card. Providers may be able to enter your Social Security Number to locate your card number. You can call 1-800-362-1504 for help.

To be eligible for Florida Medicaid, you must be a resident of the state of Florida, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

Medicaid for Aged or DisabledMedicaid for low-income individuals who are either aged (65 or older) or disabled is called SSI-Related Medicaid. Florida residents who are eligible for Supplemental Security Income (SSI) are automatically eligible for Medicaid coverage from the Social Security Administration.

If you need help finding contact information for your plan, or if you are not enrolled in a health plan, call our Medicaid Helpline at 1-877-254-1055 or visit www.ahca.myflorida.com/Medicaid.

Medicaid services may include: physician, hospital, family planning (birth control, pregnancy and birth care), home health care, nursing home, hospice, transportation, dental and visual, community behavioral health, services through the Child Health Check-Up program, and other types of services.

Website: Centers for Medicare and Medicaid Services (CMS) Contact: Contact the Centers for Medicare and Medicaid Services (CMS) Local Offices: Contact State Medicaid Offices. Toll Free: 1-800-633-4227. ... TTY: 1-877-486-2048. Forms: Centers for Medicare and Medicaid Services Forms.

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