This version of the form is not currently in use and is provided for reference only. Download this version of Form DHS-3525-ENG for the current year.

Form DHS-3525-ENG Application and Renewal Form for Medical Assistance for Women With Breast and Cervical Cancer (Ma-Bc) - Minnesota

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What Is Form DHS-3525-ENG?

This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DHS-3525-ENG?
A: DHS-3525-ENG is the Application and Renewal Form for Medical Assistance for Women With Breast and Cervical Cancer (Ma-Bc) in Minnesota.

Q: Who can apply for Medical Assistance for Women With Breast and Cervical Cancer?
A: Women in Minnesota who have been diagnosed with breast or cervical cancer and meet the eligibility criteria can apply for Medical Assistance.

Q: What is the purpose of DHS-3525-ENG?
A: The purpose of DHS-3525-ENG is to apply for or renew Medical Assistance for Women With Breast and Cervical Cancer (Ma-Bc) in Minnesota.

Q: How can I apply for Medical Assistance for Women With Breast and Cervical Cancer?
A: You can apply for Medical Assistance for Women With Breast and Cervical Cancer by completing the DHS-3525-ENG Application and Renewal Form.

Q: What information do I need to provide on the DHS-3525-ENG form?
A: The DHS-3525-ENG form requires you to provide personal information, medical information, income information, and other relevant details.

Q: Are there any fees associated with applying for Medical Assistance for Women With Breast and Cervical Cancer?
A: No, there are no fees associated with applying for Medical Assistance for Women With Breast and Cervical Cancer.

Q: How often do I need to renew my Medical Assistance for Women With Breast and Cervical Cancer?
A: You need to renew your Medical Assistance for Women With Breast and Cervical Cancer once a year.

Q: How long does it take to process the DHS-3525-ENG application?
A: The processing time for the DHS-3525-ENG application can vary, but it generally takes about 45 days.

Q: Who can I contact for more information about Medical Assistance for Women With Breast and Cervical Cancer?
A: For more information about Medical Assistance for Women With Breast and Cervical Cancer, you can contact the Minnesota Department of Human Services or your local county or tribal office.

Form Details:

Released on May 1, 2017;
The latest edition provided by the Minnesota Department of Human Services;
Easy to use and ready to print;
Quick to customize;
Compatible with most PDF-viewing applications;
Fill out the form in our online filing application.

Download a fillable version of Form DHS-3525-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.