LDSS 4294 - Explanation of the Effect of Transfer of Asset(s) on Medical Assistance Eligibility (Spanish) Read more about LDSS 4294 - Explanation of the Effect of Transfer of Asset(s) on Medical Assistance Eligibility (Spanish)
LDSS 3827 - Burial Fund Acknowledgment (Spanish) Read more about LDSS 3827 - Burial Fund Acknowledgment (Spanish)
LDSS 3559 - Residential Health Care Facility Report of Medicaid Recipient Admission-Discharge-Readmission-Change in Status Read more about LDSS 3559 - Residential Health Care Facility Report of Medicaid Recipient Admission-Discharge-Readmission-Change in Status
LDSS 3457 - Budget Worksheet - Medical Assistance - SSI-Related Budgeting and Monthly Deeming Worksheet (Parent to Child) Read more about LDSS 3457 - Budget Worksheet - Medical Assistance - SSI-Related Budgeting and Monthly Deeming Worksheet (Parent to Child)
LDSS 2400 - Child-Teen Health Program Services Read more about LDSS 2400 - Child-Teen Health Program Services
LDSS 2400 - Child-Teen Health Program Services (Spanish) Read more about LDSS 2400 - Child-Teen Health Program Services (Spanish)
LDSS 2353 - Eye Examination Clearance Blind Applicants for MA Read more about LDSS 2353 - Eye Examination Clearance Blind Applicants for MA