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Get the free Application for 1915(c) HCBS Waiver: Draft PA.029.05.00

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Application for 1915(c) HUBS Waiver: Draft PA.029.05.00 Jul 01, 2021Page 1 of 118Application for a 1915© Home and CommunityBased Services Waiver PURPOSE OF THE HUBS WAIVER PROGRAM The Medicaid Home
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Obtain application form for 1915c HCBS from the appropriate agency or healthcare provider.
02
Fill out all personal information, including name, address, date of birth, and contact information.
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Provide information about your current healthcare needs and any conditions you may have.
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Who needs application for 1915c hcbs?

01
Individuals who require home and community-based services (HCBS) under the 1915c waiver program.
02
Those who have disabilities or chronic illnesses and need assistance with daily living activities.
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1915c Home and Community-Based Services (HCBS) is a Medicaid program that allows states to provide long-term care services in home and community settings rather than institutional settings.
Individuals who require long-term care services and wish to receive them in a home or community setting are required to file an application for 1915c HCBS.
To fill out an application for 1915c HCBS, individuals can contact their state's Medicaid office or visit the official Medicaid website to access the necessary forms and instructions.
The purpose of the application for 1915c HCBS is to determine eligibility for long-term care services provided under the program and to ensure individuals receive the appropriate level of care.
Information that must be reported on the application for 1915c HCBS includes personal and medical history, current living situation, need for assistance with activities of daily living, and financial information.
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