DHHS Form 3400-A Additional Information for Select Medicaid Programs - South Carolina

DHHS Form 3400-A Additional Information for Select Medicaid Programs - South Carolina

What Is DHHS Form 3400-A?

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

FAQ

Q: What is DHHS Form 3400-A?A: DHHS Form 3400-A is a form used to provide additional information for select Medicaid programs.

Q: What is the purpose of DHHS Form 3400-A?A: The purpose of DHHS Form 3400-A is to gather additional information for select Medicaid programs in South Carolina.

Q: Who needs to fill out DHHS Form 3400-A?A: Individuals who are applying for or enrolled in select Medicaid programs in South Carolina may need to fill out DHHS Form 3400-A.

Q: Which Medicaid programs require DHHS Form 3400-A?A: Specific Medicaid programs in South Carolina may require DHHS Form 3400-A. It is best to check with the South Carolina DHHS or your Medicaid caseworker to determine if the form is needed for your specific program.

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Form Details:

  • Released on February 1, 2018;
  • The latest edition provided by the South Carolina Department of Health and Human 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 fillable version of DHHS Form 3400-A by clicking the link below or browse more documents and templates provided by the South Carolina Department of Health and Human Services.

Download DHHS Form 3400-A Additional Information for Select Medicaid Programs - South Carolina

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