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Get the 470-5482(M) - Iowa Department of Human Services ...-2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your Due Date, Case Number, County Number, and Worker Name at the top of the form.
- Carefully answer all questions regarding your household members. Ensure you provide accurate information about each member's age, relationship to you, and residency status.
- Fill in your contact information accurately. This includes your name, home address, phone number, and email address if available.
- Document your income details by listing all sources of income for each household member. Attach any proof of income to expedite processing.
- Review all sections thoroughly before signing on page 5. Your signature is essential for the form's completion.
- Submit the completed form via mail or in-person at your local DHS office by the specified deadline to maintain your Medicaid coverage.
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