Αποτελέσματα Αναζήτησης
Waivers offer an array of services and benefits such as choice of qualified providers, due process, and health and safety assurances. In Pennsylvania, the Department of Human Services administers multiple Medical Assistance/Medicaid waivers.
- Medical Assistance Provider Forms
Printable Forms. The table lists the various MA forms and...
- Medical Assistance Provider Forms
Medical Assistance (Medicaid) Financial Eligibility Application for Long Term Care, Supports and Services. Check any that you are applying for: Home and Community Waiver Services – Type/Name of Waiv. Please read the entire form. Print the requested information in the unshaded sections.
Steps to Apply for Waiver Services. STEP 1. Call the PA Independent Enrollment Broker (PA IEB) at 1-877-550-4227. • Learn more about Home and Community Based Waiver Services. • Tell PA IEB you want to apply for waiver services and schedule your first in-home visit. • Read the list of papers you need for the first in-home visit.
Medical Assistance (MA) is also known as Medicaid). It is a public health insurance program administered by the state of Pennsylvania’s Department of Human Services (DHS). MA provides a comprehensive benefit package and has very little cost-sharing.
Pennsylvania’s Medical Assistance (“Medicaid”) program includes home and community-based services waivers (“HCBS Waivers”) that fund a variety of services enabling eligible individuals with intellectual disabilities (“ID”) and/or autism to live in their own homes and communities.
Printable Forms. The table lists the various MA forms and envelopes available to providers. To view a particular form, click on VIEW PDF the table below. To order forms, complete the form at the bottom of this page. These forms are in Adobe PDF format and you must have a copy of Adobe Acrobat Reader installed on your system to view them.
Download, fill out, and print a paper application then send it to your local County Assistance Office. Download a form (PDF)
