Form 8916-A Salt Lake City Utah 2019-2025

Form 8916-A Salt Lake City Utah: What You Should Know

The ARK IDs First application does not apply to the Supplemental Application.  Use Form 1125 to apply for Medicaid or Ark IDs First or the Arkansas Works Program by  posting a copy of your completed application to any of the following locations within  the 48 contiguous states: If you choose to apply for Medicaid or ARK IDs First, there are some changes to this application.  For example:  Applicants will appear on the Arkansas Works Application and on the Supplemental Application as two  individuals instead of as both you and your relative. To be eligible to apply for Ark IDs First, you will need  to list him or her as the dependent on a birth certificate. The birth certificate will be issued by your  relative. To be eligible to apply for Medicaid or Ark IDs First, your dependent must be 16 or older,  have a parent whose full-time income is at least half of the State's average weekly wage of  724.00, and must be able to work in order to take advantage of the assistance. The Arkansas Department of Human Services has decided not to provide Ark IDs First to  families who do not apply for Medicaid, or whose insurance does not include the maximum amount of funding required by the State to provide health care services to residents of the State. The Arkansas Department of Human Services does not provide health insurance in connection with the Ark IDs First programs. The eligibility for Ark IDs First is permanent and not temporary.  We understand some following information from your completed application cannot be used to determine eligibility.  If you don 't already have health insurance, you must include details (a description, a list of medical providers, and an actual list of the services and treatments offered) to  establish that you are unable to obtain insurance without the assistance. These types of medical evidence include but are not limited to health insurance forms, insurance policies, insurance cards, and certificates. The Arkansas Health Care Assistance Commission (formerly the Arkansas Health Benefit Exchange) has determined that information you provided with respect to all your medical expenses may be used to find out about the cost of health care services and other types of public assistance offered by the State. You may file an application online or over the phone.

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