Get the free Healthy Kids Dental Amendment, submitted - State of Michigan
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Print application selector for 1915(b)Waiver: Draft MI.019.03.02 Jan 01, 2017Page 1 of 70Facesheet: 1. Request Information (1 of 2)
A. The State of Michigan requests a waiver/amendment under the authority
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How to fill out healthy kids dental amendment
How to fill out healthy kids dental amendment
01
Obtain the healthy kids dental amendment form from the appropriate provider or organization.
02
Fill out your personal information including name, address, phone number, and date of birth.
03
Provide information about your current dental insurance coverage, if applicable.
04
Complete the section regarding your child's dental health history and any previous dental treatments.
05
Review the form for accuracy and completeness before submitting it to the designated office.
Who needs healthy kids dental amendment?
01
Families with children who are eligible for the healthy kids dental program and wish to make changes or updates to their coverage.
02
Parents or guardians who want to ensure their children have access to affordable and comprehensive dental care.
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What is healthy kids dental amendment?
Healthy Kids Dental Amendment is a policy that aims to provide dental coverage for children who are eligible for Medicaid or the Children's Health Insurance Program (CHIP).
Who is required to file healthy kids dental amendment?
Dental providers who provide services to children covered under Medicaid or CHIP are required to file healthy kids dental amendment.
How to fill out healthy kids dental amendment?
Healthy kids dental amendment can be filled out online through the designated portal or by submitting a paper form to the appropriate agency.
What is the purpose of healthy kids dental amendment?
The purpose of healthy kids dental amendment is to ensure that children have access to necessary dental care and services through Medicaid or CHIP.
What information must be reported on healthy kids dental amendment?
Healthy kids dental amendment requires information such as the type of dental service provided, the child's Medicaid or CHIP ID, and the date of service.
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