tailieunhanh - WISCONSIN MEDICAID FOR THE ELDERLY, BLIND OR DISABLED APPLICATION PACKET

Each population is to be valued and protected, although the planning for each will vary to different degrees. The purpose of this paper is to focus on the elderly population, and more specifically to those who live in retirement communities or congregate care settings. There is no question that the issues addressed apply to all those who are vulnerable, but the ways in which each issue is approached will differ. The elderly easiest to locate are residents living in extended care congregate care settings. This includes the elderly at each level of care (independent, assisted, dementia care, or nursing), in a. | DEPARTMENT OF HEALTH SERVICES Division of Health Care Access and Accountability F-10101 06 11 STATE OF WISCONSIN WI Stats. . 3 WISCONSIN MEDICAID FOR THE ELDERLY BLIND OR DISABLED APPLICATION packet HOW TO APPLY This is an application for health care benefits for people who are age 65 years or older blind or have a disability. To apply for health care benefits complete this application and return it to your agency or complete an application online at . See below for more information about applying online. You will need to provide proof of some of your answers. For more information on what you will need to provide see the Verification Section on page 4. Call 1-800-362-3002 if you have questions about Medicaid or you need the address and or telephone number of your agency. If you need help filling out this application or wish to answer the questions in person or over the telephone contact your agency to set up an appointment. Information is also available online at em customerhelp. If you have a disability and need this information in an alternate format or if you need it translated to another language contact your agency. These services are free of charge. APPLY ONLINE ACCESS is an online tool that lets you apply for benefits check the status of your benefits or report changes to your worker. To visit ACCESS go to . An online application is the same as a paper application. HOW TO USE THIS FORM 1. Read the Important Information section and all the instructions before completing the application. 2. Print clearly. Use blue or black ink. 3. Write dates in the MM DD YYYY format. Example April 2 1958 would be 04 02 1958. 4. Enter information about you and or your spouse. 5. Completely fill out the application. There may be a delay in Medicaid benefits if the application is not complete. Use the checklist on page 15 to make sure your application is complete. If your application is not complete the agency will contact you for more