Get the free Molina of Washington Care Management Referral Form Fax ...

Molina of Washington Care Management Referral Form Fax: (800) 7677188 Phone: (800) 8697165 Date: Referral Source Information Person Making Referral: Office Name: Phone Number: Referring Provider:

How to fill out molina of washington care

How to fill out Molina of Washington care:

1. Start by gathering all necessary personal information, such as your full name, address, date of birth, and social security number.
2. Provide information about your current health insurance coverage, if applicable, including the name of the insurance company and policy number.
3. Next, list all household members who will be covered under Molina of Washington care, including their names, dates of birth, and relationship to you.
4. Indicate whether you or any household members are eligible for any other healthcare programs, such as Medicaid or Medicare.
5. Provide details about your income and employment, including the source of income and the amount received per month.
6. If you have any dependents, provide information about their income as well.
7. Specify if you or any household members are pregnant, as this may affect eligibility for certain programs or benefits.
8. Finally, review all the information you have provided to ensure accuracy and completeness before submitting your application.

Who needs Molina of Washington care:

1. Individuals who do not have any existing health insurance coverage and are in need of affordable healthcare options.
2. Low-income individuals and families who may be eligible for Washington State's Apple Health (Medicaid) program.
3. Pregnant women who require access to prenatal care and other maternity services.
4. Individuals with specific healthcare needs, such as those with chronic illnesses or disabilities, who may benefit from specialized care and support services.
5. Residents of Washington state who meet the eligibility criteria set by Molina of Washington, including income and residency requirements.

Overall, anyone who is seeking comprehensive and affordable healthcare coverage in Washington state may consider applying for Molina of Washington care. It is important to review the specific eligibility criteria and requirements outlined by the program to determine if you meet the qualifications.

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What is molina of washington care?

Molina of Washington Care is a healthcare program offered by Molina Healthcare in the state of Washington.

Who is required to file molina of washington care?

Individuals who are enrolled in Molina of Washington Care are required to file.

How to fill out molina of washington care?

You can fill out Molina of Washington Care by completing the necessary forms provided by Molina Healthcare.

What is the purpose of molina of washington care?

The purpose of Molina of Washington Care is to provide healthcare coverage to eligible individuals.

What information must be reported on molina of washington care?

You must report your personal information, income, and household size on Molina of Washington Care.