HFS 3120, Medicaid Payment of Medicare Cost Sharing Expenses and HFS 3757, Medicare Saving for Qualified Beneficiaries

Helping Families. Supporting Communities. Empowering Individuals.

HFS LogoDHS Logo

Information Memo

04/22/14

[signed copy on file]

Michelle R. B. Saddler

Secretary, Department of Human Services

Julie Hamos

Director, Healthcare and Family Services

Forms referenced:

HFS 3120

HFS 3120S

HFS 3757

HFS 3757S