Form DHCS7089 Screening Worksheet Disabled Widow(Er) Checklist (Dw) Ages 50 to 64 - California

Form DHCS7089 Screening Worksheet Disabled Widow(Er) Checklist (Dw) Ages 50 to 64 - California

What Is Form DHCS7089?

This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the DHCS7089 Screening Worksheet?A: The DHCS7089 Screening Worksheet is a form used in California to assess eligibility for the Disabled Widow(Er) Checklist (Dw) for individuals between the ages of 50 to 64.

Q: What is the Disabled Widow(Er) Checklist (Dw)?A: The Disabled Widow(Er) Checklist (Dw) is a program in California that provides assistance to disabled widows or widowers between the ages of 50 to 64.

Q: Who is eligible for the DHCS7089 Screening Worksheet?A: Individuals between the ages of 50 to 64 who are disabled widows or widowers in California are eligible for the DHCS7089 Screening Worksheet.

Q: What is the purpose of the DHCS7089 Screening Worksheet?A: The purpose of the DHCS7089 Screening Worksheet is to determine the eligibility of disabled widows or widowers between the ages of 50 to 64 for the Disabled Widow(Er) Checklist (Dw) program in California.

Q: What information is required on the DHCS7089 Screening Worksheet?A: The DHCS7089 Screening Worksheet requires information such as personal details, income, assets, and disabilities to assess eligibility for the Disabled Widow(Er) Checklist (Dw) program.

Q: Is there an age requirement for the DHCS7089 Screening Worksheet?A: Yes, the DHCS7089 Screening Worksheet is specifically for individuals between the ages of 50 to 64.

Q: Can I apply for the Disabled Widow(Er) Checklist (Dw) program if I am younger than 50 or older than 64?A: No, the Disabled Widow(Er) Checklist (Dw) program is only available for individuals between the ages of 50 to 64.

Q: What benefits does the Disabled Widow(Er) Checklist (Dw) program provide?A: The Disabled Widow(Er) Checklist (Dw) program in California provides financial assistance, healthcare coverage, and other support for eligible disabled widows or widowers between the ages of 50 to 64.

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Form Details:

  • Released on May 1, 2007;
  • The latest edition provided by the California Department of Health Care Services;
  • 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 Form DHCS7089 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form DHCS7089 Screening Worksheet Disabled Widow(Er) Checklist (Dw) Ages 50 to 64 - California

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