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Application for 1915(c) HUBS Waiver: SC.0675. R03.02 Jul 01, 2023 (as of Jul 01, 2023)Page 1 of 135Application for a 1915© Home and CommunityBased Services Waiver PURPOSE OF THE HUBS WAIVER PROGRAM

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How to fill out application for 1915c hcbs

01

Obtain the application form for 1915c HCBS from the relevant authority or online.

02

Fill out personal information such as name, address, date of birth, and contact details.

03

Provide information about your medical condition or disability that requires home and community-based services.

04

Include details about your income, assets, and insurance coverage.

05

Submit any supporting documentation such as medical records or assessments with the application.

06

Review the completed application form for accuracy and completeness before submission.

07

Submit the application form to the designated office or online portal as instructed.

Who needs application for 1915c hcbs?

01

Individuals with disabilities or medical conditions who require home and community-based services to maintain their independence and quality of life.

02

Caregivers or family members of individuals with disabilities who are unable to care for themselves and require assistance with daily activities.

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What is application for 1915c hcbs?

Application for 1915c HCBS is a form used to apply for Home and Community-Based Services under Medicaid.

Who is required to file application for 1915c hcbs?

Individuals who require long-term care services and supports can file an application for 1915c HCBS.

How to fill out application for 1915c hcbs?

To fill out the application for 1915c HCBS, you need to provide personal and medical information, along with details about the needed services.

What is the purpose of application for 1915c hcbs?

The purpose of the application for 1915c HCBS is to determine eligibility for receiving home and community-based care services.

What information must be reported on application for 1915c hcbs?

Information on medical conditions, living situation, financial status, and the type of services needed must be reported on the application for 1915c HCBS.

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