This version of the form is not currently in use and is provided for reference only. Download this version of Form HCA13-691 for the current year.
This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington.
The document is provided in Lao. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form HCA13-691?
A: Form HCA13-691 is an application form for the Medicare Savings Programs in Washington.
Q: What are the Medicare Savings Programs in Washington?
A: The Medicare Savings Programs in Washington are financial assistance programs that help eligible individuals pay for their Medicare premiums and out-of-pocket expenses.
Q: Who is eligible for the Medicare Savings Programs in Washington?
A: To be eligible for the Medicare Savings Programs in Washington, you must meet certain income and asset requirements.
Q: How do I apply for the Medicare Savings Programs in Washington?
A: You can apply for the Medicare Savings Programs in Washington by completing and submitting Form HCA13-691.
Q: What documentation do I need to include with my application?
A: You will need to provide documentation of your income, assets, and Medicare enrollment with your application.
Q: What happens after I submit my application?
A: After you submit your application, the Washington Health Care Authority will review your eligibility and notify you of their decision.
Q: Can I appeal if my application is denied?
A: Yes, if your application is denied, you have the right to appeal the decision.
Form Details:
Download a printable version of Form HCA13-691 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.