WV DFA-MA-1 2012-2025 free printable template

Applicant s Signature Date Signed Co-Applicant s Signature Worker s Signature Representative Completing Application Form DFA-MA-1 New 12/11 Revised 5/12. WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES APPLICATION FOR ADULT/FAMILY MEDICAID I. Applicant Information Name LAST Sex M F FIRST Date of Birth / / Month Day MI Marital Status Year Mailing Address Route and Box or Number and Street Apt. Number City/Town State Zip Code Physical Address If different than Mailing County of Residence...

How to fill out application for adultfamily medicaid

How to fill out WV DFA-MA-1

1. Obtain the WV DFA-MA-1 form from the West Virginia Department of Health and Human Resources website or your local office.
2. Provide your personal information in the designated sections (name, address, phone number, etc.).
3. Fill in details regarding your household members, including names, ages, and relationships.
4. Complete the income section by listing all sources of income for each household member.
5. Include any deductions or additional expenses as required by the form.
6. Review the provided information for accuracy and completeness.
7. Sign and date the form where indicated.
8. Submit the completed form to your local WV DHHR office either in person or through the designated submission method.

Who needs WV DFA-MA-1?

1. Individuals or families seeking financial assistance and benefits from the West Virginia Department of Health and Human Resources.
2. Those who are applying for programs such as Medicaid, food assistance, or other social services in West Virginia.

Instructions and Help about application for adultfamily medicaid

JUDY WOODRUFF And speaking of the efforts to replace the Affordable Care Act let's continue hearing how some citizens and healthcare providers see it Producer Jason Kane visited a pair of clinic sin the heart of coal country Last night we took you to the town of Wise Virginia in a state that opted not to expand Medicaid for low-income residents Just across the border in West Virginia the Affordable Care Act and its Medicaid expansion meant the rate of uninsured residents dropped from at least 21 percent before the law took effect to 9 percent in 2015 and nearly third of families in the state do get Medicaid More than 83 percent of Ming County voted for the president in the election And the state has been ravaged by the opioids epidemic But at the Williamson Health and WellnessCenter nerves are now on edge as patients recount their personal stories REBECCA HICKS West Virginia My name's RebeccaHicks, and I'm from Chatter West Virginia I'm 37 years old When I was younger I was raped I guess I got on drugs to cope with it regular pain pills First it started with you know snorting the pills Then it led to shooting the pills And I have always struggled to have a doctor And this place kind of takes care of all fit My access to Medicaid has helped me pay for medicines that I would never have been able to pay for and to see specialists that I wouldn'ttitle able to see if I didn't have that medical care JEROME CLINE Family Nurse Practitioner My name's Jerome Cline I'm a family nurse practitioner With the passage of the Affordable Care Act the state had expanded Medicaid programs Right now it's just under 50 percent of outpatients I think are Medicaid VICKI HATFIELD Family Nurse Practitioners name is Vicki Hatfield I'm a certified family nurse practitioner and a certified diabetes educator Once we started seeing more patients qualify for Medicaid they were able to come in, and we were able to start getting them caught up on their preventive screenings and health promotion activities and just be able to treat their chronic illnesses that had been neglected The increased funds for Medicaid services brought more revenue into the clinic, so that allowed us to hire more people here It also allowed us to do some other thing sin the community to promote healthy living JEROME CLINE We have a farmers market every Saturday VICKI HATFIELD We also had community gardens start And we see more people growing their own vegetables JEROME CLINE We have a community 5K almost every month And then we have a community health worker program It's certainly a lot of cheaper to keep people healthy at home than it is once they get into the system VICKI HATFIELD Now as we watch what's happening with possible repeal or replacement of the Affordable Care Act it's very concerning I know patients are concerned particularly patients who had chronic diseases that now they're able to get medications for or patients who need annual screening CONNIE SUE MASON West Virginia I have got ahead...

People Also Ask about

What is Medicaid called in West Virginia?

WV Medicaid (West Virginia Medicaid) Insurance Program. The WV Medicaid program provides healthcare to well over 500,000 low-income or disabled people each year.

What is West Virginia Medicaid called?

​​​​​​​​​​​​​​​​​​​​​​​​​The West Virginia Department of Health and Human Resources, Bureau for Medical Services (BMS), is the designated single state agency responsible for the administration of the State's Medicaid program. BMS provides access to appropriate health care for Medicaid-eligible individuals.

How do I contact West Virginia Medicaid?

​ 24-hour federal call center helpline – 1-800-318-2596 or TTY 1-855-4325.

What is WV Medicaid income limit?

Under the expanded eligibility guidelines, adults age 19-64 are eligible for Medicaid with a household income up to 138% of the poverty level. For a single adult in 2023, that amounts to $20,120 in total annual income.

What all does Medicaid cover in WV?

West Virginia Medicaid Benefits Primary care provider (PCP) visits. Immunizations and wellness visits. EPSDT (Early and Periodic Screening, Diagnosis and Treatment) services for members under 21. Specialist visits. Urgent and emergency care. Hospital care. Lab and X-ray services. Pregnancy services.

What are the different Medicaid plans in WV?

NCQA Health Insurance Plan Ratings 2019-2020 - Summary Report (Medicaid) RatingPlan NameStates4.0UNICARE Health Plan of West VirginiaWV3.0The Health Plan of the Upper Ohio Valley, Inc. dba The Health PlanWV2.5West Virginia Family Health Plan, Inc. d/b/a West Virginia Family Health (WVFH)WV1 more row

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What is WV DFA-MA-1?

WV DFA-MA-1 is a form used by the West Virginia Department of Revenue for reporting and documenting certain taxes and financial information.

Who is required to file WV DFA-MA-1?

Individuals and businesses that engage in specific taxable activities in West Virginia are required to file WV DFA-MA-1.

How to fill out WV DFA-MA-1?

To fill out WV DFA-MA-1, you need to gather the required financial information, complete the form with accurate data regarding your taxable activities, and submit it to the West Virginia Department of Revenue.

What is the purpose of WV DFA-MA-1?

The purpose of WV DFA-MA-1 is to ensure compliance with state tax regulations and to collect relevant financial data for the calculation of taxes owed in West Virginia.

What information must be reported on WV DFA-MA-1?

WV DFA-MA-1 requires reporting of income, deductions, tax credits, and other relevant financial details pertaining to the taxable activities in West Virginia.