| |  | To apply for Long Term Care assistance you must call 410-853-3270 and schedule an appointment. You are first asked a series of questions. Once the appointment has been scheduled an application packet is sent to the customer's representative to be completed and submitted at the time of the appointment. The Long Term Care unit is located on the first floor of the Drumcastle Government Center. This program provides payments to nursing homes or other institutions for elderly and disabled adults. - Prior to entering the facility was the applicant living in Baltimore County?
- Does the applicant have any resources or property that exceeds $2,500 (if married may exceed $2,500)?
- Applicant's Name
- Date of Birth
- Social Security Number
- Marital Status
- Representative Name
- Representative Address
- Daytime Phone Number
- Is applicant currently in a facility? If so, name of facility. Date admitted to the facility.
- Is the applicant privately paying for the facility?
- What months are you requesting assistance?
- Has applicant ever applied for Medical Assistance Coverage?
- Does applicant have Qualified Medicare Beneficiaries (QMB)?
Revised October 30, 2006 |
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