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HOME CARE APPLICATION An Independent Licensee of the Blue Cross and Blue Shield AssociationInstructions Please PRINT or TYPE a response for each question. Please attach the copies of the documents

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How to fill out home care application package

01

Gather all necessary documents such as identification, proof of income, insurance information, and medical history.

02

Fill out the application form completely and accurately, making sure to include all required information.

03

If applicable, include any additional forms or documents requested by the home care agency.

04

Review the completed application package to ensure everything is filled out correctly and all necessary documents are included.

05

Submit the application package to the home care agency either in person, by mail, or online as instructed.

Who needs home care application package?

01

Individuals who require assistance with daily activities such as bathing, dressing, and meal preparation.

02

Elderly individuals who may need extra support to remain living independently in their own homes.

03

Patients recovering from surgery or managing a chronic illness who need additional help with their care.

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What is home care application package?

The home care application package is a set of forms and documents that need to be completed in order to apply for home care services.

Who is required to file home care application package?

Individuals who are in need of home care services or their caregivers are required to file the home care application package.

How to fill out home care application package?

The home care application package can be filled out by completing the required forms and providing the necessary documentation as instructed.

What is the purpose of home care application package?

The purpose of the home care application package is to assess the need for home care services and determine eligibility for such services.

What information must be reported on home care application package?

The home care application package typically requires personal information, medical history, current health status, and details about the individual's daily living needs.

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