Form CMS-138 (IL401-0825) Eligibility Certification Statement - Illinois

Form CMS-138 (IL401-0825) Eligibility Certification Statement - Illinois

What Is Form CMS-138 (IL401-0825)?

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

FAQ

Q: What is Form CMS-138?
A: Form CMS-138 is the Eligibility Certification Statement for the state of Illinois.

Q: Who should fill out Form CMS-138?
A: Form CMS-138 should be filled out by individuals who are applying for or renewing their eligibility for certain healthcare programs in Illinois.

Q: What healthcare programs does Form CMS-138 apply to?
A: Form CMS-138 applies to healthcare programs such as Medicaid and the Children's Health Insurance Program (CHIP) in Illinois.

Q: What information is required on Form CMS-138?
A: Form CMS-138 requires information such as personal details, income information, and household size.

Q: How often do I need to fill out Form CMS-138?
A: You need to fill out Form CMS-138 when you initially apply for healthcare programs, and then renew it annually or as required by the Illinois Department of Healthcare and Family Services.

Q: Are there any fees to fill out and submit Form CMS-138?
A: No, there are no fees to fill out and submit Form CMS-138.

Q: Is Form CMS-138 only for Illinois residents?
A: Yes, Form CMS-138 is specifically for residents of Illinois who are applying for or renewing eligibility for healthcare programs in the state.

Q: Is there a deadline to submit Form CMS-138?
A: The deadline to submit Form CMS-138 may vary, so it's best to check with the Illinois Department of Healthcare and Family Services for specific due dates.

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Form Details:

  • Released on September 13, 2012;
  • The latest edition provided by the Illinois Department of Central Management 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 printable version of Form CMS-138 (IL401-0825) by clicking the link below or browse more documents and templates provided by the Illinois Department of Central Management Services.

Download Form CMS-138 (IL401-0825) Eligibility Certification Statement - Illinois

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