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Medical Assistance Eligibility


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Form List

Form
Document used for application, enrollment, registration or eligibility determination purposes.
 
Effective Date      Title - Owner - Description
10/01/2009  Healthy Kids Application/Aplicación, Form 800P - Division of Family Assistance, NH Healthy Kids Corporation - Low cost health insurance for infants and children to age 19, and pregnant women.  Uninsured due to high costs, no employer insurance access or other reasons.  Aplicación para el Healthy Kids Cobertura Médica.
11/01/2007  Healthy Kids Redetermination Application, Form 800PR - Division of Family Assistance, Healthy Kids Corporation - Used to determine eligibility for continuation of coverage.
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