Policy Memo - Form HFS 2378H Application for Medical Benefits

Policy Memorandum - Form HFS 2378H Application for Medical Benefits

Summary:

• Form HFS 2378H (R-04-07) Mail-In Application for Medical Benefits has been revised.
• The new form is available for downloading from the Internet at www.hfs.illinois.gov/medicalforms/. Paper copies will be available from the warehouse.
• Forms A through H are required if they pertain to the applicant.