Form DHR / FIA9709 Long-Term Care / Waiver Medical Assistance Application - Maryland

Form DHR / FIA9709 Long-Term Care / Waiver Medical Assistance Application - Maryland

What Is Form DHR/FIA9709?

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

FAQ

Q: What is Form DHR/FIA9709?
A: Form DHR/FIA9709 is the Long-Term Care/Waiver Medical Assistance Application for the state of Maryland.

Q: What is the purpose of Form DHR/FIA9709?
A: The purpose of Form DHR/FIA9709 is to apply for long-term care and waiver medical assistance in Maryland.

Q: Who can use Form DHR/FIA9709?
A: Any individual who is seeking long-term care or waiver medical assistance in Maryland can use Form DHR/FIA9709.

Q: What information is required on Form DHR/FIA9709?
A: Form DHR/FIA9709 requires personal information, financial information, and details about your medical condition and need for long-term care.

Q: Is there a fee for submitting Form DHR/FIA9709?
A: No, there is no fee for submitting Form DHR/FIA9709.

Q: How do I submit Form DHR/FIA9709?
A: You can submit Form DHR/FIA9709 by mail or in person at your local Department of Social Services office.

Q: How long does it take to process Form DHR/FIA9709?
A: The processing time for Form DHR/FIA9709 can vary, but it usually takes several weeks to receive a decision.

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Form Details:

  • Released on July 1, 2011;
  • The latest edition provided by the Maryland Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form DHR/FIA9709 by clicking the link below or browse more documents and templates provided by the Maryland Department of Health.

Download Form DHR / FIA9709 Long-Term Care / Waiver Medical Assistance Application - Maryland

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