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REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION This form may be sent to us by mail or fax: Address: BlueMedicare (HMO) Attn: Medicare D Clinical Review 2900 Ames Crossing Road Eagan,

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What is hmocd form?

The HMOCF form is the Health Coverage Tax Credit Monthly Certification and Errata Information form.

Who is required to file hmocd form?

Individuals who are eligible for the Health Coverage Tax Credit are required to file the HMOCF form.

How to fill out hmocd form?

The HMOCF form can be filled out online or by mail, providing information about eligibility and coverage.

What is the purpose of hmocd form?

The purpose of the HMOCF form is to certify eligibility for the Health Coverage Tax Credit and provide accurate information for the IRS.

What information must be reported on hmocd form?

The HMOCF form requires information such as personal details, coverage information, and certification of eligibility.

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