How to Apply for DSHS Long Term Services in Washington
This file provides essential information on how to apply for DSHS Long Term Services and Supports (LTSS) through Medicaid. It guides you through the eligibility criteria and the application process. Find out which methods to use for submitting your application efficiently.
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How do I fill this out?
To fill out this application, begin by determining your financial and functional eligibility for Medicaid. Gather the necessary personal information and documentation required for the application. Follow the detailed instructions provided in the sections below to ensure your application is completed correctly.

How to fill out the How to Apply for DSHS Long Term Services in Washington?
1
Determine your financial and functional eligibility for Medicaid.
2
Gather all necessary personal information and documentation.
3
Complete the application via the online portal or by mail.
4
Submit your application along with any additional required documentation.
5
Wait for a determination and further communication from an HCS specialist.
Who needs the How to Apply for DSHS Long Term Services in Washington?
1
Individuals over 65 who require long-term care services.
2
People with disabilities needing support for daily activities.
3
Families seeking assistance for elderly relatives requiring care.
4
Individuals transitioning from hospital to home care needing Medicaid.
5
Caregivers looking for resources to assist individuals under their care.
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What are the instructions for submitting this form?
Submit your DSHS application via online submission through the WA Health Plan Finder or by mailing it to Home and Community Services, PO Box 45826, Olympia WA 98504-5826. If needing assistance, call HCS or your local HCS office to receive help in completing your application. Don't forget to include your contact information for follow-up.
What are the important dates for this form in 2024 and 2025?
While specific dates may vary, it’s crucial to submit applications as soon as possible to avoid delays in obtaining services. Always check with local HCS offices for any updates regarding application deadlines in future years.

What is the purpose of this form?
The purpose of this form is to assist individuals in applying for DSHS Long Term Services and Supports through Medicaid. It outlines both financial and functional eligibility criteria, ensuring applicants are informed about the requirements. By completing the form, applicants enable themselves to access necessary health services tailored to their needs.

Tell me about this form and its components and fields line-by-line.

- 1. Personal Information: Includes name, address, and date of birth.
- 2. Financial Information: Details regarding income and resources.
- 3. Care Needs: Information about personal care requirements.
- 4. Medical Information: Includes medical history and medications.
What happens if I fail to submit this form?
If you fail to submit this form, you will be unable to access the necessary long-term services and supports provided by DSHS. Lack of submission may delay essential services that support your health and well-being.
- Delay in Services: Not submitting the application delays access to needed support and care.
- Eligibility Issues: Failure to apply means you cannot determine your eligibility for Medicaid.
- Increased Stress: Not knowing your service options can create additional stress for individuals and families.
How do I know when to use this form?

- 1. Applying for Long-Term Care: Use this form to start the application process for long-term care services.
- 2. Determining Medicaid Eligibility: Essential for individuals seeking to understand their Medicaid eligibility options.
- 3. Getting Support for a Disability: Crucial for those with disabilities needing additional support.
Frequently Asked Questions
How do I apply for DSHS long-term services?
To apply, complete an application online or by mail. Ensure you provide all relevant information about your financial and functional eligibility.
Can I get help filling out the application?
Yes, you can ask an HCS staff person for assistance during the application process.
What happens after I submit my application?
A financial services specialist will contact you to determine your eligibility after reviewing your submitted application.
Is there a deadline for application submission?
It’s best to submit your application as soon as you determine your need for services to avoid delays.
Can I track my application status?
Yes, you will be notified about your application status via phone or mail.
What information do I need to provide?
You’ll need to provide personal care needs, medical records, and any current supports you have in place.
Are online applications processed faster?
Online applications can provide real-time eligibility determination, speeding up the process.
Can I change my application details after submission?
Yes, you can contact the HCS office to update any incorrect information after submission.
Do I need to enroll in Medicaid before applying?
No, the application for DSHS services includes the Medicaid enrollment process.
What should I do if my application is denied?
You will receive a detailed letter explaining the denial, and you have the option to appeal the decision.
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