Information Memo: HFS 3120, Medicaid Payment of Medicare Cost Sharing Expenses and HFS 3757-Medicare Savings for Qualified Beneficiaries

3/29/2012

Information Memo: HFS 3120, Medicaid Payment of Medicare Cost Sharing Expenses and HFS 3757-Medicare Savings for Qualified Beneficiaries

Summary:

• Form HFS 3120 (pdf)/3120S (pdf), Medicaid Payment of Medicare Cost Sharing Expenses, has been revised.
• Form HFS 3757(pdf)/3757S (pdf), Medicare Savings for Qualified Beneficiaries, has been revised. 
• Forms are available online at www.hfs.illinois.gov/medicalbrochures.

HFS 3120 (pdf)/3120S(pdf) (R-01-12) and HFS 3757(pdf)/HFS 3757S(pdf) (R-02-12), may be downloaded at www.hfs.illinois.gov/medicalbrochures.