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Get Sc Dhhs Form 400 2021-2025

888-549-0820 and tell the customer service representative the language you need. We ll get you help at no cost to you. TTY users should call 1-888-842-3620. DHHS Form 400 (Aug 2021) Application for Medicaid and Affordable Health Coverage Page 1 of 5 STEP 1 We ll keep all the information you provide private and secure as required by law. We ll use personal information only to check if you re eligible for health coverage. Your Information 1. First name, Middle name, Last name and Suff.

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