Form EA-FSSA Application for South Dakota Medicaid / Chip, Health Coverage & Help Paying Costs - South Dakota

Form EA-FSSA Application for South Dakota Medicaid / Chip, Health Coverage & Help Paying Costs - South Dakota

What Is Form EA-FSSA?

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

FAQ

Q: What is the Form EA-FSSA?
A: Form EA-FSSA is an application for South Dakota Medicaid/Chip and health coverage, as well as help paying costs.

Q: Who can use the Form EA-FSSA?
A: Residents of South Dakota who need Medicaid/Chip or health coverage and assistance with costs can use the Form EA-FSSA.

Q: What is Medicaid/Chip?
A: Medicaid/Chip is a program that provides health coverage for low-income individuals and families.

Q: What type of help with costs can be obtained through the Form EA-FSSA?
A: The Form EA-FSSA can help individuals and families with costs such as medical expenses, prescriptions, and health insurance premiums.

Q: What information do I need to fill out the Form EA-FSSA?
A: You will need information about your household, income, expenses, and any current health coverage you have.

Q: What happens after I submit the Form EA-FSSA?
A: After submitting the form, the Department of Social Services will review your application and determine your eligibility for Medicaid/Chip and assistance with costs.

Q: How long does it take to process the Form EA-FSSA?
A: The processing time for the Form EA-FSSA can vary, but you should receive a decision on your application within 45 days.

Q: Can I appeal if my application is denied?
A: Yes, if your application is denied, you have the right to appeal the decision and request a hearing to review your case.

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Form Details:

  • Released on October 1, 2016;
  • The latest edition provided by the South Dakota Department of Social 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 EA-FSSA by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.

Download Form EA-FSSA Application for South Dakota Medicaid / Chip, Health Coverage & Help Paying Costs - South Dakota

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