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Commonwealth of Kentucky KY Medicaid Provider Billing Instructions For Qualified Medicare Beneficiary Provider Type 82, 87, 88, 89, 91 and 95 Version 5.0 December 12, 2013, Document Change Log Document

How to fill out 91 and 95

How to fill out 91 and 95:

1. Start by gathering all the necessary information for forms 91 and 95. These forms typically require details such as the individual's personal information, including their name, address, social security number, and contact information.
2. Carefully review the instructions provided for each form. Ensure that you understand the specific requirements and any additional documentation that may be needed.
3. Begin filling out form 91 by entering the required personal details in the designated fields. This form is commonly used for reporting tax credits, deductions, and exemptions. Double-check for accuracy and make sure all the information is entered correctly.
4. Move on to form 95, which is typically used for reporting health coverage exemptions. Follow the instructions provided and provide all the necessary information. This form may require details about your health insurance coverage or any exemptions that apply to you.
5. Once you have completed both forms, carefully review them to ensure accuracy and completeness. Make sure there are no errors or missing information. It is helpful to double-check all the entered data against the relevant documents before submitting the forms.

Who needs 91 and 95:

1. Individuals who file taxes and need to report specific tax credits, deductions, and exemptions may need to fill out form 91.
2. Form 95 is typically needed by individuals who qualify for certain exemptions from health coverage requirements. This form allows them to report and claim those exemptions.
3. It is advisable to consult with a tax professional or review the official guidelines provided by the relevant authorities to determine if forms 91 and 95 are required based on your specific circumstances.

Remember to always consult official sources or seek professional advice to ensure compliance and accuracy when filling out forms such as 91 and 95.

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