Aim saratoga application 2025

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104 votes

The document is an application form for the Access for Infants and Mothers (AIM) program, designed to provide health coverage for pregnant women in California. It includes sections for personal information, health plan choices, family size and income details, declarations regarding pregnancy status, authorizations for medical information, and a checklist of required documents. The application emphasizes the importance of submitting accurate information and necessary documentation to ensure eligibility for the program.

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Click ‘Get Form’ to open the aim saratoga application in the editor.
Begin with SECTION 1, providing your personal information. Fill in your last name, first name, and address. If a question does not apply, simply write 'N/A'. Remember that submitting a Social Security Number is optional.
In SECTION 2, select your 1st and 2nd choices of health plans. Refer to the provided pages for available options in your county and ensure you complete any required fields related to medical groups or provider codes.
Move on to SECTION 3, where you will detail family size, income, and insurance information. Be thorough in documenting income sources and frequency as this is crucial for eligibility.
Complete SECTION 4 by declaring your understanding of the program's requirements. Ensure you sign and date the application at the end.
Finally, review all sections for completeness before submitting your application via mail as instructed.

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Versions	Form popularity	Fillable & printable
2008	4.8 Satisfied (104 Votes)

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