Form ODM07216 Application for Health Coverage and Help Paying Costs - Ohio

Form ODM07216 Application for Health Coverage and Help Paying Costs - Ohio

What Is Form ODM07216?

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

FAQ

Q: What is ODM07216?
A: ODM07216 is the application form used in Ohio to apply for health coverage and help with paying healthcare costs.

Q: Who can use form ODM07216?
A: Any resident of Ohio who needs health coverage or financial assistance with healthcare costs can use form ODM07216.

Q: What information is required on form ODM07216?
A: Form ODM07216 requires personal and household information, income details, and information about current health coverage, if any.

Q: What happens after submitting form ODM07216?
A: After submitting form ODM07216, your eligibility for health coverage and help with healthcare costs will be determined and you will be notified of the outcome.

Q: Is there a deadline for submitting form ODM07216?
A: There is no specific deadline for submitting form ODM07216, but it is recommended to apply as soon as possible to ensure timely processing of your application.

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Form Details:

  • Released on July 1, 2014;
  • The latest edition provided by the Ohio Department of Medicaid;
  • 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 ODM07216 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.

Download Form ODM07216 Application for Health Coverage and Help Paying Costs - Ohio

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