- 1). Obtain a copy of the necessary form from your state's Medicaid website or from your local Medicaid office. You can obtain contact information for your state's Medicaid office from the National Association of State Medicaid Directors website.
- 2). Complete all portions of the form. Do not leave any portions of the form blank. If you have any questions about how to complete any sections of the form, consult with a caseworker at your local Medicaid office. If a section of the form does not apply to you, write "N/A" unless the form instructs you to leave it blank or complete not applicable sections in another way.
- 3). Submit the form to the appropriate Medicaid office. Forms that should be submitted to your local Medicaid office include the initial application and notice of change forms. If you are appealing the denial of coverage for a medical procedure, contact your state Medicaid office to find out where this form should be submitted. If you have questions about where to submit any other forms, your local or state Medicaid office can instruct you on where to submit the forms.
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