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2012-2025 Form

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Video instructions and help with filling out and completing New York State Health Care Proxy Form

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Instructions and help about New York State Health Care Proxy Form

Woman: IN OUR DEMO TODAY, WE WILL BE GOING THROUGH AN APPLICATION FOR A FAMILY -- A SINGLE MOM, JOSEPHINE, AND HER SON, MARVIN. BOTH OF THEM ARE LOOKING TO PAY FOR HEALTHCARE COVERAGE. AT THIS POINT IN OUR SCENARIO, JOSEPHINE HAS CREATED AN ACCOUNT AND HAS BEEN IDENTITY-PROOFED. AND ACCOUNT HOLDERS ARE IDENTITY-PROOFED SO THAT THE MARKETPLACE CAN PROTECT A CONSUMER'S PERSONAL INFORMATION AND PRIVACY. ON THIS FIRST PAGE OF THE APPLICATION, WE ENTER IN BASIC INFORMATION ABOUT THE FAMILY. WE ASK CONSUMERS TO INCLUDE THEMSELVES, THEIR SPOUSE, ANY CHILDREN THEY ARE TAKING CARE OF, AND ANYONE THEY WILL INCLUDE ON THEIR FEDERAL TAX RETURN. JOSEPHINE'S INFORMATION WAS PRE-POPULATED FROM THE ACCOUNT-CREATION PROCESS. SHE ENTERS IN INFORMATION ABOUT MARVIN. WHEN FILLING OUT THE APPLICATION, IT'S IMPORTANT TO CLICK ON THE BLUE BOX AT THE TOP OF THE SCREEN IF YOU WANT THE MARKETPLACE TO SEE IF YOU QUALIFY FOR FEDERAL FINANCIAL ASSISTANCE. ON THE FIRST SET OF SCREENS, WE ASK

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2012-2025 Form

How it works

Create this form in 5 minutes or less

Video instructions and help with filling out and completing New York State Health Care Proxy Form

Instructions and help about New York State Health Care Proxy Form

Create this form in 5 minutes!

How to create an eSignature for the new york state health care proxy form

How to create an electronic signature for a PDF online

How to create an electronic signature for a PDF in Google Chrome

How to create an e-signature for signing PDFs in Gmail

How to create an e-signature right from your smartphone

How to create an e-signature for a PDF on iOS

How to create an e-signature for a PDF on Android

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