3871b 2025

Show details

4.9 out of 5

52 votes

The document is a Maryland Medical Assistance Medical Eligibility Review Form (#3871B) used to assess eligibility for various medical services, including nursing facilities and waivers. It includes sections for service requests, client demographics, mental health assessments, diagnoses, skilled services required, functional assessments, and certification by healthcare professionals.

Here's how it works

01. Edit your dhmh 3871b online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send 3871b form via email, link, or fax. You can also download it, export it or print it out.

The easiest way to edit 3871b in PDF format online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Adjusting paperwork with our extensive and intuitive PDF editor is easy. Adhere to the instructions below to complete 3871b online easily and quickly:

Sign in to your account. Log in with your email and password or register a free account to try the service before choosing the subscription.
Upload a form. Drag and drop the file from your device or import it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
Edit 3871b. Quickly add and underline text, insert images, checkmarks, and icons, drop new fillable areas, and rearrange or delete pages from your document.
Get the 3871b accomplished. Download your adjusted document, export it to the cloud, print it from the editor, or share it with others through a Shareable link or as an email attachment.

Take advantage of DocHub, the most straightforward editor to rapidly manage your paperwork online!

See more 3871b versions

We've got more versions of the 3871b form. Select the right 3871b version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2011	4.9 Satisfied (52 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a 3871 form in Maryland?

A form used to determine the need for nursing home care (Form 3871) is then sent to the Delmarva Foundation for a determination of medical eligibility.

What is the monthly income limit for Medicaid in Maryland?

Financial assistance is available on a limited basis through the Senior Assisted Living Subsidy Program or the Medicaid Waiver Home and Community Based Services Program. The Medicaid Program may also pay for a limited number of residents of small assisted living facilities.

Who is eligible for Medicaid waiver in Maryland?

Security Interest Filing Statement can be used to record a lien on an existing certificate of title OR for the original lien holder to re-assign the security interest in a vehicle. The certificate of title must accompany two-copies of the Security Interest Filing Statement.

Try more PDF tools