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Form HCA13-866 Diabetic Limitation Extension Request - Washington
What Is Form HCA13-866?
This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form HCA13-866?
A: Form HCA13-866 is the Diabetic Limitation Extension Request form.
Q: Who is this form for?
A: This form is for individuals in Washington who have diabetes and need to request an extension for their coverage limitations.
Q: What is the purpose of this form?
A: The purpose of this form is to request an extension for coverage limitations related to diabetes.
Q: Do I need to fill out this form?
A: You need to fill out this form if you have diabetes and need to request an extension for your coverage limitations.
Form Details:
- Released on August 1, 2016;
- The latest edition provided by the Washington State Health Care Authority;
- 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 HCA13-866 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.
Download Form HCA13-866 Diabetic Limitation Extension Request - Washington
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