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Medical Assistance - Department of Human Services

    https://www.dhs.pa.gov/Services/Assistance/Pages/Medical-Assistance.aspx
    Online: Using the COMPASS website, you can apply for MA and many other services that can help you make ends meet. Telephone: Call the Consumer Service Center for Health …

Downloadable Medical Assistance Provider Forms

    https://www.dhs.pa.gov/docs/Publications/Pages/Medical-Assistance-Provider-Forms.aspx
    Forms Available to Order The Office of Medical Assistance Programs (OMAP) produces and distributes over 70 forms and envelopes for provider use at no charge to the …

COMPASS HHS Printable Forms - compass.state.pa.us

    https://www.compass.state.pa.us/compass.web/MenuItems/PrintableForms.aspx?Language=EN
    Use the following links to view and/or print application forms: Application for Health Care Coverage - PA 600HC. Application for Benefits (SNAP, Health Care, Cash Assistance) - …

Department of Human Services

    https://www.dhs.pa.gov/Services/Assistance/Documents/Benefits%20Applications/PA-600-2-20-Final.pdf
    Department of Human Services

Forms - Department of Human Services

    https://www.dhs.pa.gov/docs/Pages/Forms.aspx
    Assistance; Children; Disabilities & Aging; Mental Health in PA; Mass Care and Emergency Assist; Other Services; Find a Document. Find a Document; For Providers; …

Medical Assistance (Medicaid) Financial Eligibility …

    https://www.dhs.pa.gov/Services/Assistance/Documents/Benefits%20Applications/PA%20600%20L%20AS%20—%20Financial%20Eligibility.pdf
    county assistance office for help. You should attach verification to this form. Persons who have given away assets (income or resources) within the past 60 months, or set up or …

Pennsylvania Medicaid Program | Benefits.gov

    https://www.benefits.gov/benefit/1148
    Who is eligible for Pennsylvania Medicaid Program? To be eligible for Pennsylvania Medicaid, you must be a resident of the state of Pennsylvania, a U.S. national, citizen, …

Prior Authorization FAQ - Department of Human Services

    https://www.dhs.pa.gov/providers/FAQs/Pages/Prior-Authorization-FAQ.aspx
    The MA 97 - Outpatient Services Authorization Request form is used to request a medical service/supply that requires prior authorization/program exception. The MA 97 Prior …

Pennsylvania Medicaid Prior Authorization Form - PDF – …

    https://eforms.com/prior-authorization/medicaid/pennsylvania/
    A Pennsylvania Medicaid prior authorization form is required to obtain Medicaid coverage for non-preferred drugs in the State of Pennsylvania. Filled out by a physician or pharmacist, this form must …



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