Form F-10130 Medicaid Presumptive Disability - Wisconsin

Form F-10130 Medicaid Presumptive Disability - Wisconsin

What Is Form F-10130?

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

FAQ

Q: What is Form F-10130?
A: Form F-10130 is a Medicaid Presumptive Disability form used in Wisconsin.

Q: What is Medicaid Presumptive Disability?
A: Medicaid Presumptive Disability is a program that provides temporary Medicaid coverage for individuals who have a presumptive disability.

Q: Who is eligible for Medicaid Presumptive Disability?
A: Individuals who have a presumptive disability, are Wisconsin residents, and meet the income and asset requirements may be eligible for Medicaid Presumptive Disability.

Q: How do I apply for Medicaid Presumptive Disability?
A: You can apply for Medicaid Presumptive Disability by completing and submitting Form F-10130 to your local Wisconsin Division of Health Services (DHS) office.

Q: What information is required on Form F-10130?
A: Form F-10130 requires information about your personal details, health condition, income, assets, and other relevant information.

Q: What happens after I submit Form F-10130?
A: After you submit Form F-10130, the Wisconsin Division of Health Services (DHS) will review your application and determine your eligibility for Medicaid Presumptive Disability.

Q: How long does Medicaid Presumptive Disability coverage last?
A: Medicaid Presumptive Disability coverage is temporary and typically lasts up to six months.

Q: Can I renew my Medicaid Presumptive Disability coverage?
A: Yes, you can renew your Medicaid Presumptive Disability coverage by reapplying and meeting the eligibility requirements.

Q: What other Medicaid programs are available in Wisconsin?
A: Wisconsin offers various Medicaid programs, including BadgerCare Plus, Family Planning Only Services, and Elderly, Blind, and Disabled (EBD) Medicaid.

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Form Details:

  • Released on August 1, 2017;
  • The latest edition provided by the Wisconsin Department of Health 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 Form F-10130 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-10130 Medicaid Presumptive Disability - Wisconsin

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