Form HCA50-0142 Pebb Certification of a Child With a Disability - Washington

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Form HCA50-0142 Pebb Certification of a Child With a Disability - Washington

What Is Form HCA50-0142?

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 HCA50-0142?
A: Form HCA50-0142 is the Pebb Certification of a Child With a Disability form used in Washington.

Q: What is PEBB Certification?
A: PEBB Certification refers to the process of certifying that a child has a disability in order to qualify for certain benefits.

Q: Who needs to fill out this form?
A: This form needs to be filled out by a parent or guardian of a child with a disability who is applying for benefits.

Q: What benefits does this form qualify a child for?
A: This form is used to determine eligibility for certain benefits, such as healthcare coverage and special education services.

Q: Is there a deadline for submitting this form?
A: There may be specific deadlines for submitting this form, so it is recommended to check with the relevant agencies or programs for more information.

Q: What documents are required to accompany this form?
A: Documentation of the child's disability may be required, such as medical records or an evaluation from a qualified professional.

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Form Details:

  • Released on September 1, 2022;
  • 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 HCA50-0142 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.

Download Form HCA50-0142 Pebb Certification of a Child With a Disability - Washington

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