Health Insurance Form Templates

This document is an application form for health insurance in Colorado. It also provides assistance for paying health insurance costs.

This document is used for applying for long-term care or waiver in the state of Connecticut.

This form is used for applying for the Medicaid/Medicare Buy-In program in Florida.

This form is used for applying for extended family planning benefits under health insurance in the state of Florida.

This form is used for applying for health coverage in Louisiana through the BHSF program.

This Form is used for applying for Medicaid enrollment in the state of Montana. It is used by individuals who meet the eligibility requirements and wish to receive healthcare coverage through the Medicaid program.

This Form is used for applying for health coverage and financial assistance in North Carolina.

This Form is used for applying for health coverage and financial assistance in the state of Vermont.

This Form is used to apply for health coverage in the state of Vermont. It is specifically for residents who need to apply for insurance benefits.

This Form is used for applying for or making changes to health insurance coverage in the state of Wisconsin.

This form is used for applying for child care assistance in Idaho.

This application is a legal document used to apply for and enroll in Marketplace health coverage with the DHHS.

File this renewal form annually in order to renew your Medicare coverage.

This document provides a case study on Kaiser Permanente's healthcare system, focusing on its performance and achievements.

This form is used for applying to the Texas Health Insurance Premium Payment (HIPP) Program in order to receive help paying for health insurance premiums.

This document provides instructions for completing USCIS Form I-944, which is the Declaration of Self-sufficiency. This form is used for assessing an immigrant's ability to support themselves financially and avoid becoming a public burden in the United States. It requires detailed information on the applicant's income, assets, liabilities, and use of public benefits.

This form is used for declaring self-sufficiency to the United States Citizenship and Immigration Services (USCIS).

This form is used for individuals in California to authorize an assistant to act on their behalf in matters related to the Department of Managed Health Care (DMHC).

This document is an application for individuals or organizations to act as a discount medical plan in the state of Louisiana.

This Form is used for requesting prior authorization for the medication Daliresp in the state of Nevada.

This form is used for employers in Utah to provide health insurance information. It is required by the Department of Health (DOH) and helps ensure that employees have access to the necessary health insurance coverage.

This form is used for submitting a retroactive claim for Medicaid in the state of Texas.

This form is used for requesting a forced change of medical coverage in the state of Texas.

This form is used for transmitting medical bills and insurance information in Texas. It is available in both English and Spanish.

This form is used for recertification of Medical Assistance Only (MAO) in Texas. It is used to update and verify an individual's eligibility for medical assistance.

This form is used to apply for the Medicaid Buy-In program for children in Texas.

This form is used for gathering additional information from the parent who has custody in Texas to determine children's health-care benefits.

This form is used for verifying the existence and validity of a health insurance policy in the state of Texas.

This form is used for Medicaid managed care members in Texas to indicate a gap in enrollment.