Please rate Dhs 3531 Form Eng 6-26
Use this application to apply for health care coverage for long-term care (LTC) or services to help you stay in your home or other settings in the community.
Not for: do not use this application to apply for health care coverage for family members other than the person applying for LTC.
Proofs: send copies of proofs, not original documents; the proofs you send must be the most recent proof available.
Send: mail or take the application to your county or tribal nation agency; send it right away even if you do not have all proofs.
AVS form: read the Asset Verification Service form in Attachment A; complete and return it if it applies to you, your spouse, or sponsors.
Representative: a legally appointed representative for someone on this application must submit proof with the application.
| Question | Answer |
|---|---|
| Form Name | Form DHS-3531-ENG |
| Form Length | 30 pages |
| Fillable? | Yes |
| Fillable fields | 671 |
| Avg. time to fill out | 60+ min |
| Other names | DHS-3531, DHS 3531, DHS3531, DHS-3531-ENG, 3531, Form 3531, MA-LTC application, Application for Medical Assistance for Long-Term Care Services |
| Edition | 6-26 |
| Where to send | Your county or tribal nation agency, with copies of proofs (not original documents) |
| Official source | Form DHS-3531-ENG (Rev 6-26), Minnesota Department of Human Services |
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Please rate Dhs 3531 Form Eng 6-26
