Dma 5200 application-2025

Get Form
dhb 5002 Preview on Page 1

Here's how it works

01. Edit your dhb 5002 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 dma 5002 via email, link, or fax. You can also download it, export it or print it out.

The best way to modify Dma 5200 application in PDF format online

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2

Working on paperwork with our comprehensive and user-friendly PDF editor is simple. Adhere to the instructions below to fill out Dma 5200 application online quickly and easily:

  1. Sign in to your account. Sign up with your credentials or register a free account to try the product before choosing the subscription.
  2. Import a document. Drag and drop the file from your device or import it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
  3. Edit Dma 5200 application. Effortlessly add and highlight text, insert pictures, checkmarks, and signs, drop new fillable areas, and rearrange or remove pages from your paperwork.
  4. Get the Dma 5200 application accomplished. Download your adjusted document, export it to the cloud, print it from the editor, or share it with other participants using a Shareable link or as an email attachment.

Make the most of DocHub, one of the most easy-to-use editors to quickly manage your paperwork online!

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.
Contact us
Everyone is potentially eligible for emergency Medicaid as long as they meet the income and North Carolina state residence eligibility requirements (provide proof they live in North Carolina, such as photo ID with your address, a utility bill, a lease or documentation of employment).
Prepare the following documents below for each person applying to help complete your application: Full legal name. Date of birth. Social Security number (or immigration documents) North Carolina residency. Income information (from paystubs, W-2 forms, tax returns or business records)
How long does it take for my Medicaid application to be processed? 45 to 90 days, depending upon the program for which the person qualifies. For Special Assistance, the processing timeframes are: 45, 60, or 90 days.
An adult ages 19-64 may be eligible if the family income is $2,351/month or less. An adult ages 65+ may be eligible for full Medicaid if the family income is $1,704/month or less, and for other programs if the family income is $2,300/month or less.
The medically needy asset limit is $2,000 for an individual and $3,000 for a couple. 2) Asset Spend Down Persons who have assets over Medicaids asset limit can still become asset-eligible by spending down excess assets on non-countable assets.

Facts about dma 5200 application

The DMA 5200 application is a crucial tool for individuals and families seeking to determine their eligibility for health coverage and financial assistance in North Carolina.

Use cases of the form

Form filing requirements

How to submit the dma 5200 application?

Other important aspects to understand about completing dma 5200 application

Use cases of the form

This application is primarily intended for residents of North Carolina who are looking to apply for Medicaid or the North Carolina Health Choice program. It is suitable for individuals, families, and children, including those with varying income levels. For instance, a family of four earning up to $94,000 annually may still qualify for low-cost or free health insurance options. Additionally, immigrants can apply on behalf of their children without affecting their immigration status.

Form filing requirements

To successfully file the DMA 5200 application, applicants must provide specific documentation and adhere to deadlines. The completed application should be submitted to the local Department of Social Services (DSS) office. If all required information is not available at the time of submission, applicants are encouraged to submit the form anyway and will receive follow-up instructions within one to two weeks.

  • Complete all sections of the application accurately.
  • Provide Social Security Numbers or document numbers for legal immigrants.
  • Include proof of identity and North Carolina residency.

How to submit the dma 5200 application?

Submitting the DMA 5200 application involves several steps: first, obtain a copy of the form from your local DSS office or online; next, fill out all required sections thoroughly; then sign the application; finally, either mail it or deliver it in person to your local County Department of Social Services.

  1. Obtain a copy of the DMA 5200 application from http://www.ncdhhs.gov/dma/medicaid/applications.htm.
  2. Fill out all necessary information regarding yourself and your family members.
  3. Sign the completed application.
  4. Submit it by mailing or delivering it in person to your local County DSS office.

Other important aspects to understand about completing dma 5200 application

It is essential that applicants understand that submitting this form does not obligate them to purchase health coverage. Furthermore, any changes in circumstances must be reported within ten days as they could affect eligibility. Confidentiality is maintained throughout this process as mandated by law.

  • The DMA 5200 form can be used by individuals even if they already have health coverage.
  • Assistance is available in multiple languages through local DSS offices.
  • Applicants can receive help with filling out this form from local DSS offices or via phone support.
be ready to get more

Complete this form in 5 minutes or less

Get form

People also ask

What documents and information do you need for your Medicaid application? Your name and date of birth. Your Social Security number. Your monthly payment amounts for rent, mortgage, or utilities. Proof of citizenship or immigration status. Proof of income, like paystubs or W-2s.

dma 5200