Medicaid Family Planning Services - Renewal Waiver
Notice
This is to notify you that on 00/00/200X the first year your
extended benefits for FAMILY PLANNING will end. To receive this service
for another year you need to:
- Completely fill out the enclosed application.
- Mail or bring the application to your local health department.
Your health department will notify you if your application is
approved or denied. Call the Family Health Line at 1-800-451-2229 if
you have any questions.
If you need an application in Spanish or Haitian Creole, please call
the Family Health Line at 1-800-451-2229.
