Important: Stay covered! Are you enrolled in Apple Health (Medicaid) coverage? Make sure your address and phone number are up to date so you can stay enrolled. Report a change.
Income Best Estimate guide
Revised Date:
July 25, 2014
Obtain proof of income (e.g., pay stub, employer statement, tax return) from the individual to answer the following: | |
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Rate of pay: |
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Pay dates: |
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Past income: |
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Recent changes: |
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Changes expected during the certification period: |
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