Pa 600b application 2026

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The document provides instructions for completing the Medicaid Eligibility Application (Form PA 600B) for the Breast and Cervical Cancer Prevention and Treatment (BCCPT) Program. It outlines the necessary information to be filled by both the applicant and the healthcare provider, including personal details, diagnosis codes, and eligibility criteria. The form also includes sections for voter registration and rights and responsibilities related to Medicaid application.

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Click ‘Get Form’ to open the PA 600B application in the editor.
In Part I, enter your name, marital status, birthdate, and sex. Ensure all information is printed clearly or typed.
Provide your home address and contact details. If applicable, include a mailing address that differs from your home address.
Indicate your citizenship status and provide any necessary immigration documentation if you are not a U.S. citizen.
Fill in your household income and answer questions regarding health insurance coverage and dependents.
In Part II, ensure that a provider completes the required fields including diagnosis date, ICD-10 code, and their signature.
Review all sections for accuracy before submitting the form via fax or mail as instructed at the end of the document.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (98 Votes)
2019	4.3 Satisfied (36 Votes)
2019	4.8 Satisfied (69 Votes)
2017	4.8 Satisfied (108 Votes)
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2011	4.2 Satisfied (51 Votes)
2011	4.8 Satisfied (61 Votes)
2011	4.8 Satisfied (86 Votes)
2010	4.9 Satisfied (481 Votes)

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How long does it take to get approved for medical assistance in PA?

PA 600 R (AS) 9/18. Benefits Review. This is an application for cash, health care and SNAP benefits. If you need this application in another language or someone to interpret, please contact your local county assistance office. Language assistance will be provided free of charge.

What is the monthly income limit for medical assistance in PA?

The PA-BCCEDP provides low-income, uninsured, and underinsured women access to and cervical cancer screenings and diagnostic services, including mammograms, Pap tests, and diagnostic testing if abnormal results are found: - From 2015-2020, over 29,600 PA women were served by the program.

What is the PA and cervical cancer Program?

PA-BCCEDP, formerly called the HealthyWoman Program, is a program of the PA Department of Health that provides free mammograms, clinical and pelvic exams, pap tests, and follow-up diagnostic tests for an abnormal screening result.

What is the PA and cervical cancer Early Detection Program?

Verification and Approval Once you submit your Medicaid application, it will undergo a verification process to check your information and ensure everything is correct. Usually, youll hear back within about 30 days, but it can sometimes take a bit longer.

Pa 600b application 2026

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