Health Care for Seniors

Forms and Tool Kits

• Advance Directive for Health Care

  This Advance Directive for Health Care form can be completed online. Click this link to go to a website where you can create an "Advance Directive for Health Care" that you can print, sign and have witnessed. The site will ask you a series of questions about your health care choices and then create an Advance Directive for Health Care based on YOUR ANSWERS. PLEASE NOTE: This is NOT a fill-in-the-blank form. IMPORTANT: If you use Mozilla, you must select Word or Wordpad when the program assembles the document. Content Detail

  By:

  Atlanta Legal Aid Society, Inc.

• Advance Directive for Health Care PDF

  This new Advance Directive for Health Care form replaces the former Living Will and the former Durable Power of Attorney for Health Care. Content Detail

  By:

  Georgia Department of Human Resources, Division of Aging Services

• Ask for a Fair Hearing for Medicaid Benefits

  You can ask for a fair hearing (an appeal) if: • You have been denied Medicaid • Your Medicaid benefits have been cut • Your Medicaid benefits have changed. If you want a fair hearing, call your county Department of Family and Children’s Services today. Then fill out this form. Bring it or mail it to your county Department of Family and Children Services. Read More

  By:

  Georgia Legal Services Program®

• Georgia Common Point of Access to Social Services

  COMPASS is a quick and easy way for people in Georgia to get answers to questions about health and human services. Content Detail

• Georgia Medicare Savings Program Applications

  This site will allow you to apply online for the type of Medicaid that provides partial financial assistance with Medicare premiums, deductibles and co-payments to certain low income Medicare beneficiaries. Content Detail

  By:

  US Department of Health and Human Services

• Georgia Medicare Savings Program Applications

  This site will allow you to apply online for the type of Medicaid that provides partial financial assistance with Medicare premiums, deductibles and co-payments to certain low income Medicare beneficiaries. Content Detail

  By:

  US Department of Health and Human Services

• Limited Financial Power of Attorney for QIT

  This Limited Financial Power of Attorney for QIT (or Miller Trust) form can be completed online. Click this link to go to a website where you can create a "Limited Financial Power of Attorney" that you can print, sign and have witnessed. The site will ask you a series of questions about your financial choices and then create a Limited Financial Power of Attorney based on YOUR ANSWERS. PLEASE NOTE: This is NOT a fill-in-the-blank form. IMPORTANT: If you use Mozilla, you must select Word or Wordpad when the program assembles the document. Content Detail

  By:

  Atlanta Legal Aid Society, Inc.

• OSAH Form 1 - DFCS Request for Fair Hearing with Office of State Administrative Hearings

  When you have been denied Medicaid or had your Medicaid Benefits lowered or terminated, you can ask for a fair hearing. You can fill out a fair hearing request letter and mail it or deliver it to your local Division of Family and Children Services (DFCS) office to begin the process. When DFCS gets your letter asking for a fair hearing, they use this form to process your appeal with the Office of State Administrative Hearings (OSAH). You can give DFCS this form and ask them to fill it out and send it to OSAH and to the Department of Human Resources Legal Services to process your appeal. Read More

  By:

  Georgia Department of Human Resources

• TANF/Food Stamps/Medicaid Application

  This is an interactive program to assist people in completing the initial application for TANF, Food Stamps and Medicaid. You must user INTERNET EXPLORER to access this program. The initial application is the first step in the application process. This program will take you to another website where you will register, login and then complete an interview. After you have completed the interview, you will be able to print the completed application. Content Detail