Transcription of APPLICATION FOR LONG-TERM CARE SERVICES
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Questions? 1-800-230-0690 Page | 1 APPLICATION FOR LONG-TERM CARE SERVICESM edicaid Benefits for People Needing LONG-TERM Care Fill out this APPLICATION to see if you qualify for LONG-TERM care SERVICES coverage through medicaid . This program is only for those who are planning to live or now live in a nursing facility, group home, or developmental center in Louisiana, or who have been offered an opportunity through Home and Community-Based SERVICES (HCBS) or the Program of All-Inclusive Care for the Elderly (PACE). If you need extra space, use a separate sheet of paper or the space provided for you on page 13. If you have any questions, call 1-800-230-0690 from Monday Friday to speak with a medicaid representative.
Medicaid Benefits for People Needing Long-Term Care • Fill out this application to see if you qualify for long-term care services coverage through Medicaid. This program is only for those who are planning to live or now live in a nursing facility, group home, or developmental center in .
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