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BRC12471.indd Creative Designation: New Last Save Date: 12-12-2013 1:50 PM User Name: Chambers, Catherine L Station Name: WWIL124181 Job Info Segment: Fulfillment Campaign: Alaska EBT Brochure Cell: None WR #: 110121 Partner: TSS PremiumID: None RPC: None Creative

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Application for Services - Alaska Department of …

dpaweb.hss.state.ak.us

Application for Services State of Alaska Department of Health and Social Services Division of Public Assistance http://dhss.alaska.gov/dpa/ If you need help filling out this form or have questions, please tell us —

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rev 03/2018 FPL = Federal Poverty Level for Alaska

dpaweb.hss.state.ak.us

rev 03/2018 FPL = Federal Poverty Level for Alaska . MAGI MEDICAID INCOME ELIGIBILITY STANDARDS – FPL BASED Effective 4/01/2018 Household Size . Pregnant Women . Children-Under age 19 . With Insurance : Children-Under age 19 Without Insurance Expansion Group .

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Application for Services - Home | DPAweb

dpaweb.hss.state.ak.us

Sep 22, 1996 · Application for Services . If you need help filling out this form or have questions, please tell us — ... and retirement ImmigrationStatus: immigration or naturalization papers (not ... change in wage rate, change from part-time to full-time, or full-time to part-

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rev 12/2021 FPL = Federal Poverty Level for Alaska

dpaweb.hss.state.ak.us

Apr 01, 2021 · FPL = Federal Poverty Level for Alaska : Title: 2022 Medicaid Income Eligibility Standards Author: Windows User Subject: This document is the Medicaid Income Eligibility Standards as well as historical standards for the last four years in multiple categories, whether it is COLA based, FPL based, and more.

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Medicaid Application for Adults and Children with Long ...

dpaweb.hss.state.ak.us

This application is only for Medicaid benefits for an individual needing Long Term Care services and supports. If you are completing the application on behalf of someone who needs the assistance, including a child, please answer all questions as if that individual was completing the form. Be sure the form is complete.

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Application for Heating Assistance

dpaweb.hss.state.ak.us

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