Additional income and property information needed for medi-cal - dhcs ca 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Case Name, Case Number, Worker’s Name, and Worker’s Phone Number at the top of the form.
3. In the Additional Household Information section, check the appropriate boxes if applicable. Provide names where required for members living apart or step-parents.
4. For income details, indicate 'Yes' or 'No' for each type of income received by household members. Attach proof of any income marked 'Yes'.
5. In the Expenses section, similarly check 'Yes' or 'No' for each expense type and provide documentation for any marked 'Yes'.
6. Proceed to the Property and Possessions section. Check 'Yes' or 'No' for each property type owned and provide necessary documentation as specified.
7. Complete any additional sections as required based on your responses, ensuring all questions are answered accurately.

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