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Get Pa Care 600 2006-2024

Specifique) ________________________ This form is for two programs: Medicaid (also known as Medical Assistance) and CHIP (Children’s Health Insurance Program). All information you provide on this form will be shared between the two programs if necessary. It is confidential. Medicaid: Provides health care coverage for children under age 21, pregnant women, and other adults. CHIP: Provides health care coverage for children under age 19 who do not have health insurance and who are not eligibl.

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