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For Office Use Only ID #: Gen Los SPD AP Candidate Recd:Montgomery County State Health Insurance Assistance Program (SHIP) www.MedicareABCD.org 3012554250 SHIP@AccessJCA.org2021 Medicare Drug Plan

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How to fill out state health insurance assistance

01

Contact your state health insurance assistance program.

02

Ask for information on the application process.

03

Gather all necessary documents such as proof of income, residency, and identification.

04

Fill out the application form accurately and completely.

05

Submit the application either online, by mail, or in person.

06

Follow up with the program to ensure your application is processed in a timely manner.

Who needs state health insurance assistance?

01

Individuals who are looking for assistance in understanding their health insurance options.

02

People who need help with Medicare enrollment or coverage.

03

Anyone eligible for Medicaid but unsure of how to apply.

04

Seniors or individuals with disabilities who need help navigating the healthcare system.

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What is state health insurance assistance?

State health insurance assistance provides support and guidance to individuals seeking help with their health insurance options.

Who is required to file state health insurance assistance?

Individuals who need assistance with their health insurance coverage are required to file for state health insurance assistance.

How to fill out state health insurance assistance?

You can fill out the state health insurance assistance application either online, in-person at a local office, or over the phone.

What is the purpose of state health insurance assistance?

The purpose of state health insurance assistance is to help individuals navigate and understand their health insurance options.

What information must be reported on state health insurance assistance?

You may need to report personal information, income, household size, and current health insurance coverage on the state health insurance assistance application.

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