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Get the free Healthy Way LA Eligibility Status Request - file lacounty

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This form is used by providers to request verification of enrollment status for clients in the Healthy Way LA program. It collects necessary client information such as name, DMH IS Number, date of
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How to fill out healthy way la eligibility

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How to fill out Healthy Way LA Eligibility Status Request

01
Obtain the Healthy Way LA Eligibility Status Request form from the official website or a local health office.
02
Fill in your personal information, including your name, address, and contact details.
03
Indicate your income level and household size on the form.
04
Provide any required documentation to support your application, such as pay stubs or tax documents.
05
Review the completed form for accuracy and completeness.
06
Submit the form to the designated local county office or through the online portal.

Who needs Healthy Way LA Eligibility Status Request?

01
Individuals who are low-income and need access to health care services.
02
Residents of Los Angeles County who are uninsured or underinsured.
03
Anyone seeking to enroll in the Healthy Way LA program for health coverage.
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In general, however, the income limits are low. In most states in 2025, the income limit for receiving long-term care at home or in a nursing home through Medicaid is $2,901/month.
The Recipient Eligibility Verification System (REVS) is a toll-free telephonic eligibility hotline that has been in place for several years and is used to verify Medicaid recipient eligibility. REVS has two telephone numbers. The toll free number is (800) 776-6323.
Eligibility can be verified through: The Medicaid Eligibility Verification System (MEVS). Providers can accept verification of enrollment in Louisiana Healthcare Connections from the MEVS system in lieu of the ID card. Online through our secure provider portal. By phone using our automated IVR system, 1-866-595-8133.
You will need to bring current proof of identification, income, expenses, assests, disability, and support.
Effective 3/1/2025 ProgramFamily Size/Monthly Income Limits 12 LaCHIP Affordable Plan - for children $3,326 $4,495 LaMOMS - for pregnant women $2,433 Medicaid Purchase Plan - for workers with disabilities $1,305 $1,7636 more rows
1:03 2:41 And ensures that the verification. Process is efficient and accurate. In summary verifying MedicaidMoreAnd ensures that the verification. Process is efficient and accurate. In summary verifying Medicaid eligibility is an ongoing process that should be done before each clinical.

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Healthy Way LA Eligibility Status Request is a form used to determine an individual's eligibility for the Healthy Way LA program, which provides access to health care services for low-income residents in Los Angeles County.
Individuals seeking to enroll in the Healthy Way LA program or those needing to update their eligibility status are required to file the Healthy Way LA Eligibility Status Request.
To fill out the Healthy Way LA Eligibility Status Request, individuals must complete the required form accurately with personal information, household details, and income information as requested.
The purpose of the Healthy Way LA Eligibility Status Request is to assess an individual's financial situation and determine their eligibility for health care coverage under the Healthy Way LA program.
The information that must be reported includes personal identification details, household composition, income sources and amounts, and any other relevant information as requested on the form.
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