BFA Form 779 Application for Retroactive Medical Assistance - New Hampshire

BFA Form 779 Application for Retroactive Medical Assistance - New Hampshire

What Is BFA Form 779?

This is a legal form that was released by the New Hampshire Department of Health and Human Services - Bureau of Family Assistance - a government authority operating within New Hampshire. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is BFA Form 779?
A: BFA Form 779 is the application for Retroactive Medical Assistance in New Hampshire.

Q: What is Retroactive Medical Assistance?
A: Retroactive Medical Assistance is a program that helps eligible individuals pay for medical expenses that were incurred before they applied for Medicaid.

Q: Who is eligible to apply for Retroactive Medical Assistance?
A: Eligibility for Retroactive Medical Assistance depends on various factors, including income and resources. It is best to contact the New Hampshire Department of Health and Human Services for specific eligibility criteria.

Q: How do I apply for Retroactive Medical Assistance?
A: To apply for Retroactive Medical Assistance, you need to complete BFA Form 779 and submit it to the New Hampshire Department of Health and Human Services. It is recommended to contact them for detailed instructions and guidance on the application process.

Q: Are there any deadlines for applying for Retroactive Medical Assistance?
A: Yes, there are deadlines for applying for Retroactive Medical Assistance. It is important to contact the New Hampshire Department of Health and Human Services to find out the specific deadlines and requirements.

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Form Details:

  • Released on July 1, 2019;
  • The latest edition provided by the New Hampshire Department of Health and Human Services - Bureau of Family Assistance;
  • 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 BFA Form 779 by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Health and Human Services - Bureau of Family Assistance.

Download BFA Form 779 Application for Retroactive Medical Assistance - New Hampshire

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