Dhs 3531-2025

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The document is an application form for Medical Assistance for Long-Term Care Services (MA-LTC) in Minnesota. It outlines the process for applying for health care coverage related to long-term care, including services in nursing homes and home-based support programs. The application requires personal information, proof of income and assets, and a long-term care consultation assessment before services can be paid. It also provides instructions on how to complete the form, contact information for assistance, and details about privacy practices and rights regarding personal information.

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