Dc Health Link Application Form

Forms & Resources DC Health Link

Forms 37 People Used

Application Forms for DC Exemptions: Decline Medicaid Coverage Form: Medicaid Reimbursement Request Form: Special Enrollment Eligibility Criteria: Employer forms & resources: File Type: Modified: Making a Partial Online Payment: New Employers Creating an Account : Existing Employers First Login to Updated DC Health Link: Employers Manage …

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Application For Health Coverage & Help DC Health Link

Health 59 People Used

Use blue or black ink to complete this application. Tell us about yourself. (We need one adult in the family to be the contact person for your application.) Initial here: Page 1 of 3 STEP 1 1. First name Middle name Last name Suffix 2. Home address (Leave blank if you don’t have one.) 3. Apartment or suite number 4. City 5. State 6. ZIP code 7.

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Application For Exemption

For 25 People Used

Call DC Health Link at (855) 532-5465, or go to www.dchealthlink.com. Page 1 of 6 Application for Exemption From the Individual Responsibility Requirement for Individuals Who Experience Hardships Use this application to apply for a hardship exemption from the individual responsibility requirement. • All DC residents and their dependents must have health …

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Application For Exemption

For 25 People Used

Call DC Health Link at (855) 532 -5465, or go to www.dchealthlink.com. Page 1 of 7 . Application for Exemption . From the Individual Responsibility Requirement for Individuals Who are Unable to Afford Coverage . Use this application to apply for an affordability exemption from the individual responsibility requirement. • All DC residents and their dependents need to have …

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Application Form For Coverage With Financial Assistance

Form 56 People Used

Get help from a trained expert by calling 1 (855) 532-5465 or going to the DC Healthlink website. Print out the Application Form for Coverage with Financial Assistance for Individuals . Mail the application to: DC Health Link Department of Human Services Case Record Management Unit P.O. Box 91560 Washington, DC 20090. Or Fax it to: (202) 671-4400

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Welcome To DC Health Link DC Health Link

Health 41 People Used

2013-2022 District of Columbia Health Link. All Rights Reserved. 1-855-532-5465 / TTY: 711 [email protected] GET HELP

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Welcome To DC Health Link DC Health Link

Health 41 People Used

Welcome to the District's Health Insurance Marketplace; Call Customer Service . 1-855-532-5465 / TTY:711. Welcome to DC Health Link Welcome to the District's Health Insurance Marketplace. Employee Portal Consumer/Family Portal Assisted Consumer/Family Portal Returning User Employer Portal Broker Agency Portal General Agency Portal HBX Portal Broker Registration …

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Application Form For Coverage With Financial Dhs.dc.gov

Form 57 People Used

Get help from a trained expert by calling 1 (855) 532-5465 or going to the DC Healthlink website. Print out the Application Form for Coverage with Financial Assistance for Individuals . Mail the application to: DC Health Link Department of Human Services Case Record Management Unit P.O. Box 91560 Washington, DC 20090. Or Fax it to: (202) 671-4400

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How To Apply For DC Medicaid? Dhcf

How 35 People Used

Washington, DC 20011. Phone: (202) 576-8000. For answers to your questions on how to apply, please call the DC Health Link Customer Service at 1-855-532-5465. After you submit your application, it can take up to 45 days (or 60 days if you are disabled) for you to hear whether you have been approved for enrollment into the Medicaid program.

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COMBINED APPLICATION FOR D Dcra.dc.gov

COMBINED 39 People Used

If you want to file an on-line application for Medicaid go to the DC Health Link Website at DC HealthLink.com. You can also call the DC HealthLink Customer Service Center toll-free at 1-888-532-5465 for help applying. GOVERNMENT OF THE DISTRICT OF COLUMBIA DEPARTMENT OF HUMAN SERVICES January 2015 version Your Information Last Name

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Medicaid DC Health Link

Medicaid 24 People Used

Individuals without dependent children (childless adults), parents/caretaker relatives, children up to age 21, and pregnant women can submit a DC Health Link application for financial assistance to pay for health coverage to be screened and determined eligible for Medicaid if all eligibility factors are met.

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Related Topics

Frequently Asked Questions

How do i get help with dc health link?

Get Expert Help Guides and Resources Fight Fraud Glossary Insurance Company Contacts Enroll Now Login Create Account For Assisters Forms Consumer Info Sheet This form is for Assisters to provide to consumers. The form should be completed by the consumer so all their essential DC Health Link information is kept in one place.

How do i apply for medicaid in washington dc?

Washington, DC 20011 Phone: (202) 576-8000 For answers to your questions on how to apply, please call the DC Health Link Customer Service at 1-855-532-5465 After you submit your application, it can take up to 45 days (or 60 days if you are disabled) for you to hear whether you have been approved for enrollment into the Medicaid program.

Where can i find information about dc health services?

Use our DC Health Service Telephone Directory to view the telephone numbers for various DC Health services. The DC Health and Wellness Center provides free and confidential clinical services for persons over 13 years of age and older.

What is dc medicaid and how does it work?

District of Columbia Medicaid is a joint federal-state health insurance program that provides health care coverage to low-income and disabled adults, children and families. To be eligible for DC Medicaid, you must be a resident of the District of Columbia and must meet non-financial and financial eligibility requirements.

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