SC DHHS 3400 2014 free printable template
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Is PERSON 3 currently living in a DJJ group home 15. Does PERSON 4 want help paying for medical bills from the last 3 months 37. YEARLY INCOME Complete only if PERSON 4 s income changes from month to month. If you have more than four people to include ask for and complete DHHS Form 3400-01 for each additional person. STEP 3 1. Are you or is anyone in your family American Indian or Alaska Native If NO skip to Step 4. YES. If YES ask for and comple...
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How to fill out SC DHHS 3400
How to fill out SC DHHS 3400
01
Obtain the SC DHHS 3400 form from the official South Carolina Department of Health and Human Services website or local office.
02
Fill in your personal information at the top of the form including your name, address, and contact details.
03
Provide details about your household members, including their names and relationships to you.
04
Indicate your income sources and amounts, including wages, Social Security, and any other income.
05
Complete the sections related to your expenses, such as housing costs, utility bills, and medical expenses.
06
Review the form for accuracy and completeness before signing and dating it.
07
Submit the completed form to the appropriate department as instructed, either in-person or online.
Who needs SC DHHS 3400?
01
Individuals and families seeking assistance with medical coverage or financial support from the South Carolina Department of Health and Human Services.
02
Residents of South Carolina who need financial assistance or access to health services through the DHHS programs.
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People Also Ask about
What is the asset limit for Medicaid in South Carolina?
Income & Asset Limits for Eligibility 2023 South Carolina Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleIncome LimitAsset LimitInstitutional / Nursing Home Medicaid$2,742 / month*$2,000Medicaid Waivers / Home and Community Based Services$2,742 / month†$2,0001 more row • Feb 27, 2023
What is proof of income for Medicaid in SC?
Copies of pay stubs for the last 4 weeks or a letter from your employer that shows your last 4 weeks of GROSS pay.
What is the monthly income for Medicaid in SC?
Monthly Net Income Limit may not exceed $1,699 per month. The individual's resources must not exceed $2,000.
What is the most you can make to still qualify for Medicaid in SC?
South Carolina Medicaid? Household Size*Maximum Income Level (Per Year)1$14,5802$19,7203$24,8604$30,0004 more rows
What is the highest income to qualify for Medicaid in SC?
More than one income table may be applicable if more than one eligibility category appears to be appropriate.Breast & Cervical Cancer Program. Family SizeMonthly Income (Eff. 03/01/2023)Annual Income (Eff. 03/01/2023)12,430.0029,160.0023,287.0039,440.0034,144.0049,720.0045,000.0060,000.005 more rows
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What is SC DHHS 3400?
SC DHHS 3400 is a form used by the South Carolina Department of Health and Human Services to collect information related to Medicaid services and eligibility.
Who is required to file SC DHHS 3400?
Individuals applying for Medicaid or those who have changes in their eligibility status are required to file SC DHHS 3400.
How to fill out SC DHHS 3400?
To fill out SC DHHS 3400, you need to provide personal information, income details, and any relevant documentation to support the application.
What is the purpose of SC DHHS 3400?
The purpose of SC DHHS 3400 is to evaluate eligibility for Medicaid services and to ensure that the correct benefits are provided to applicants.
What information must be reported on SC DHHS 3400?
Information that must be reported on SC DHHS 3400 includes personal identification details, household income, and any changes in circumstances affecting eligibility.
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