This version of the form is not currently in use and is provided for reference only. Download this version of Form FIS0279 for the current year.
This is a legal form that was released by the Michigan Department of Insurance and Financial Services - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form FIS0279?
A: Form FIS0279 is the Annual Notice of Medicaid Claims for Michigan.
Q: Who receives Form FIS0279?
A: Form FIS0279 is received by individuals who are enrolled in the Medicaid program in Michigan.
Q: What is the purpose of Form FIS0279?
A: The purpose of Form FIS0279 is to provide individuals with a summary of their Medicaid claims for the previous calendar year.
Q: What information is included in Form FIS0279?
A: Form FIS0279 includes information such as the total amount of Medicaid claims paid on behalf of the individual, the types of services received, and any deductibles or copayments paid.
Q: When is Form FIS0279 sent out?
A: Form FIS0279 is typically sent out in the first quarter of the year, after the end of the calendar year for which it provides a summary of claims.
Q: What should I do if I notice any errors on Form FIS0279?
A: If you notice any errors on Form FIS0279, you should contact your Medicaid caseworker or the appropriate agency listed on the form to report the error and request any necessary corrections.
Q: Is Form FIS0279 necessary for filing taxes?
A: While Form FIS0279 provides information about Medicaid claims, it is not necessary for filing taxes. Consult with a tax professional for guidance on reporting Medicaid benefits on your tax return.
Q: Can I request a copy of Form FIS0279 if I didn't receive one?
A: Yes, you can contact your Medicaid caseworker or the appropriate agency listed on the form to request a copy of Form FIS0279 if you did not receive one.
Q: What other documentation may be required for Medicaid eligibility?
A: In addition to Form FIS0279, other documentation such as income verification, identification, and proof of residency may be required for Medicaid eligibility. Contact your Medicaid caseworker for a complete list of required documents.
Form Details:
Download a fillable version of Form FIS0279 by clicking the link below or browse more documents and templates provided by the Michigan Department of Insurance and Financial Services.