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Application for 1915(c) HUBS Waiver: UT.1246. R01.07 Oct 01, 2022 (as of Oct 01, 2022)Page 1 of 150Application 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 a copy of the 1915c HCBS application form from the relevant agency or organization.

02

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

03

Provide information about your medical condition or disability that makes you eligible for 1915c HCBS.

04

Include details about the type of services and support you are seeking through the program.

05

Submit any required documentation, such as medical records or proof of income, with your application.

06

Review the completed application for accuracy and completeness before submitting it.

Who needs application for 1915c hcbs?

01

Individuals with disabilities or chronic medical conditions who require long-term services and supports to live independently in the community may need to apply for 1915c HCBS.

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What is application for 1915c hcbs?

The application for 1915c HCBS is a request for home and community-based services under the Medicaid program that allows states to offer services and support to individuals with developmental disabilities or other eligible conditions.

Who is required to file application for 1915c hcbs?

Typically, individuals with disabilities, their guardians, or caregivers are required to file the application for 1915c HCBS to access necessary services.

How to fill out application for 1915c hcbs?

To fill out the application for 1915c HCBS, you need to provide personal and medical information, details about the individual's condition, and documentation supporting the need for services. It is recommended to follow the provided guidelines and consult with a case manager if available.

What is the purpose of application for 1915c hcbs?

The purpose of the application for 1915c HCBS is to assess eligibility for receiving home and community-based services under Medicaid, facilitating support for individuals to live independently in their communities.

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

The application must report personal identification information, medical history, specific needs for services, and any existing support systems or treatments currently in place.

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