Get Hfs 3654 Illinois Form

Understanding the HFS 3654 Illinois form can be crucial for those applying for long-term care assistance. However, several misconceptions may lead to confusion. Here are four common misunderstandings:

• Misconception 1: The form is only for individuals currently residing in a nursing home.

Many believe that the HFS 3654 form is exclusively for nursing home residents. In reality, it is also applicable to individuals who are planning to move into a nursing home or are considering long-term care options. This form helps assess financial eligibility for medical assistance, regardless of current living arrangements.

• Misconception 2: You do not need to provide tax returns if you haven't filed recently.

Some applicants think that if they haven’t filed a tax return in the last 60 months, they don’t need to provide any documentation. However, the form requires all applicants to disclose their tax filing history and submit copies of tax returns for the past three years if they have filed during that time.

• Misconception 3: Assistance from family members does not need to be disclosed.

Another common belief is that help from family members or friends in managing finances can be kept private. The form specifically asks for details about anyone assisting with financial matters. Transparency about these relationships is essential for a complete evaluation of financial eligibility.

• Misconception 4: The form is optional for those seeking assistance.

Some individuals may think that completing the HFS 3654 form is optional. In fact, it is a mandatory step in the application process for those seeking medical assistance for long-term care. Failing to submit this form could delay or even prevent access to necessary services.

When filling out the HFS 3654 Illinois form, it is important to adhere to specific guidelines to ensure accuracy and completeness. Below are some recommended practices and things to avoid.

• Do: Answer all questions completely and accurately. Ensure that every section is filled out to the best of your ability.
• Do: Sign the document at the designated area. Your signature is necessary for the submission to be valid.
• Do: Provide copies of any required documents, such as tax returns or divorce decrees, as specified in the instructions.
• Do: Include your current mailing address if it differs from the address provided in the application.

• Don't: Leave any questions unanswered. Incomplete forms may delay processing or result in denial of assistance.
• Don't: Submit the form without reviewing it for accuracy. Errors can lead to complications in your application.
• Don't: Forget to include information about any financial assistance you have received or are currently receiving.
• Don't: Submit the form without a copy of your identification if required. This may be necessary for verification purposes.

Hfs 3654 Illinois: Usage Instruction

Completing the HFS 3654 form is an important step in providing additional financial information for long-term care applicants in Illinois. After filling out the form, it will need to be submitted to the appropriate healthcare or family services department. Ensure all information is accurate and complete to avoid delays in processing.

1. Read the Instructions: Carefully review the instructions provided with the form to understand what information is required.
2. Fill in Personal Information: Enter your last name, first name, middle initial, street address, city, state, county, zip code, and phone number in the designated fields.
3. Mailing Address: If your mailing address differs from your residential address, provide that information in the appropriate section.
4. Income Tax Returns: Indicate whether you have filed a state or federal income tax return in the last 60 months. If yes, specify the years and prepare copies of your tax returns for the last three years.
5. Previous Residences: If you are currently living in a nursing home, list the last two places you lived before moving there. If not, provide the last two addresses where you resided.
6. Nursing Care Payment: Describe how you have been paying for your nursing care prior to this application.
7. Financial Assistance: Indicate if someone has been helping you manage your finances. If yes, provide their name, address, phone number, and relationship to you.
8. Power of Attorney: If the person assisting you is your power of attorney (POA), indicate this and specify whether it is for property or health.
9. Consultations: State whether you have discussed your need for nursing home care with a financial planner, attorney, or family member within the last 60 months. If yes, provide the names and contact details of those individuals.
10. Marital Status: Select your current marital status and, if applicable, provide the name, address, phone number, and Social Security Number (SSN) of your spouse.
11. Deceased Spouse Information: If your spouse is deceased, list the date and place of death.
12. Insurance Policy: Indicate if you have an insurance policy that covers nursing home care. If yes, provide the policy number, insurance company name, and who receives the payments.
13. Inheritance Details: State whether you have inherited any money, property, or assets in the last 60 months. If yes, provide the amount, date received, and details about the deceased person from whom you inherited.

After completing all sections, review the form for accuracy. Finally, sign and date the document before submitting it to the appropriate department.