Fillable NOTE This is NOT an application for full Medicaid, cash assistance, or food stamps - dss sd

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DSS-EA-270 11/03 South Dakota Application for Medicare Savings Program NOTE: This is NOT an application for full Medicaid, cash assistance, or food stamps. If you want to apply for these programs, contact your local Social Services office. This application CAN be used for a single person or a couple (self and spouse). 1. INSTRUCTIONS: AGENCY USE ONLY Read the application carefully and follow all instructions given...
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