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APPLICATION FOR HOOSIER HEALTHLINE FOR CHILDREN AND PREGNANT WOMEN SUPPLEMENT OFFICE USE ONLY Case Understate Form 48904 (R / 100) / FI 2031NAME OF PERSON FILING APPLICATION: INTERVIEWER: IMMIGRATION
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How to fill out application for hoosier healthwise

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How to fill out application for hoosier healthwise

01
To fill out an application for Hoosier Healthwise, follow these steps:
02
Gather necessary documents such as proof of income, proof of residency, proof of identity, and social security numbers for all household members.
03
Visit the Indiana Medicaid website or call the Indiana Family and Social Services Administration to obtain an application form.
04
Fill out the application with accurate and complete information. Make sure to provide all required information and double-check for any errors.
05
Attach the necessary documents to the application, including copies of proof of income, residency, and identity.
06
Review the application to ensure everything is filled out correctly and all required documents are attached.
07
Submit the application either online, by mail, or in person at a local Division of Family Resources (DFR) office.
08
Wait for a notification from Hoosier Healthwise regarding the status of your application.
09
If approved, follow the instructions provided to enroll in the Hoosier Healthwise program and start accessing healthcare services.
10
Note: It is important to provide accurate and up-to-date information on the application to avoid any delays or complications in the eligibility determination process.

Who needs application for hoosier healthwise?

01
The Hoosier Healthwise program is designed for low-income individuals and families in Indiana who meet certain eligibility requirements. It is specifically intended for:
02
- Pregnant women
03
- Children under the age of 19
04
- Parents or caretakers of dependent children
05
- Adults between the ages of 19 and 64 who are not eligible for Medicare
06
Individuals and families who do not have access to other forms of health insurance may also qualify for Hoosier Healthwise. It is important to check the specific eligibility criteria and income guidelines to determine if you or someone you know needs to apply for this program.
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Hoosier Healthwise is a health care program for children and pregnant women in Indiana.
Parents or guardians of eligible children, as well as pregnant women, are required to file an application for Hoosier Healthwise.
The application for Hoosier Healthwise can be filled out online, by phone, or in person at a local Division of Family Resources office.
The purpose of the application for Hoosier Healthwise is to determine eligibility for the health care program.
The application for Hoosier Healthwise requires information such as household income, family size, and proof of pregnancy if applicable.
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