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Get the free CalAIm 1915b Waiver Application - DHCS - CA.gov

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UCC Medicare Advantage Plan with Rx and Dental Benefits Plan Enrollment Application EMPLOYER ID: ___ [ ] NEW EMPLOYER MEMBER ID: ___ [ ] EXISTING MEMBER* *If you are an existing member and/or annuitized
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Who needs calaim 1915b waiver application?

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Individuals who require long-term care services and wish to receive them through a Medicaid 1915b waiver program.
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People with disabilities or chronic illnesses who meet the eligibility criteria for the 1915b waiver program.
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Families or caregivers of individuals who meet the eligibility criteria and wish to apply for the 1915b waiver program on their behalf.
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Calaim 1915b waiver application is a form used to request a waiver for certain requirements under the Medicaid program.
Individuals or organizations seeking to waive specific Medicaid requirements are required to file calaim 1915b waiver application.
Calaim 1915b waiver application can be filled out by providing all required information and supporting documentation as specified on the form.
The purpose of calaim 1915b waiver application is to request a waiver for specific Medicaid requirements in order to provide more flexibility in program implementation.
Calaim 1915b waiver application must include information about the specific requirements being waived, justification for the waiver, and any supporting documentation.
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