To discuss another person’s case, please download the Authorization to Obtain or Release Health Care Information form and send the completed form to Imaging Center 4, PO Box 2027 Cedar Rapids, IA 52406 or fax to 51.įor information on how to apply for Nursing Facility Medicaid visit the Long Term Care page. If you were directed here from the DHS benefits portal because you do not have an email address, download the Application for Health Coverage and Help Paying Costs ( Solicitud de cobertura mádica y sistencia para abonar el costo) to apply. You can then email the completed form to see the instructions on the form for a complete list of ways to submit. To report a change to an existing case, please download and complete this form. To apply for Health Care, go to the online DHS benefits portal or download the paper Application for Health Coverage and Help Paying Costs ( Solicitud de cobertura mádica y sistencia para abonar el costo).
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