Publications
Form used to notify Medicaid/Medical Assistance customers of their rights pertaining to the release of protected health information and other personal data.
Form that notifies applicants of their rights. Original to applicant, copy in record.
Solicitud de Seguro de Salud
Document to advise when child(ren) becomes District ward(s)s. Accordingly, they have been coded out of a former AR/AX Medicaid cases. They have NOT been coded out of their former TANF and Food Stamps households.
The local resource listing for the homeless contains information on basic services, hotline numbers, addresses, phone numbers, and examples of resources to those in need of shelter or other social services.
DC HealthCare Alliance (Alliance) is ONLY for people who live in Washington, DC. If you are applying for medical assistance through the DC HealthCare Alliance, you must show that you are a DC resident.
You can show that you live in DC with:
If you are using the Proof of Residency Form, these frequentlly asked questions may help you.
Focused Improvement Area (FIA) - Trinidad - Rosedale
Focused Improvement Area (FIA) - Congress Heights
Si usted vive en D.C., puede usar este formulario para solicitar beneficios. Si necesita ayuda con este formulario, pídale ayuda a sutrabajador u otro empleado de IMA.
También puede llamar al (202) 724-5506.
Pages
