State Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana

State Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana

What Is State Form 35937?

This is a legal form that was released by the Indiana State Board of Accounts - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana?A: Form 35937 is a Medicaid recipient claim form in Indiana that helps defray burial costs.

Q: Who can use Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana?A: The form is for Medicaid recipients in Indiana who need assistance with burial costs.

Q: What is the purpose of Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana?A: The purpose of the form is to request reimbursement from Medicaid to help cover burial expenses.

Q: What information is required on Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana?A: The form asks for information such as the deceased's name, date of birth, date of death, and details of the funeral expenses.

ADVERTISEMENT

Form Details:

  • Released on February 1, 2020;
  • The latest edition provided by the Indiana State Board of Accounts;
  • 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 State Form 35937 by clicking the link below or browse more documents and templates provided by the Indiana State Board of Accounts.

Download State Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana

4.8 of 5 (10 votes)
  • State Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana

    1

  • State Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana, Page 2

    2

  • State Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana, Page 1
  • State Form 35937 Medicaid Recipient Claim to Defray Burial Costs - Indiana, Page 2
Prev 1 2 Next
ADVERTISEMENT