Real and Personal Property--Supplement to Medi-Cal Mail-In Application MC 322 2026

Get Form
dpss 4384 form Preview on Page 1

Here's how it works

01. Edit your dpss 4384 form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send dpss 4384 via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Real and Personal Property--Supplement to Medi-Cal Mail-In Application MC 322 with our platform

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open it in the editor.
  2. Begin with Section 1, where you will check the boxes next to the types of financial institution accounts you have. Fill in the owner’s name, account number, current value, and financial institution details for each account.
  3. Move to Section 2 and provide information about your real property. Include the address or legal description, ownership details, occupancy status, and any relevant financial information such as full value and amount owed.
  4. In Section 3, indicate your business-related assets by checking 'Yes' or 'No' for various items. Provide detailed descriptions and values for any business equipment or real property.
  5. Continue to Sections 4 through 6, listing vehicles, other valuable items like jewelry or insurance policies, and any transfers of property within the last 30 months. Ensure all fields are completed accurately.

Start using our platform today to easily complete your application for free!

See more Real and Personal Property--Supplement to Medi-Cal Mail-In Application MC 322 versions

We've got more versions of the Real and Personal Property--Supplement to Medi-Cal Mail-In Application MC 322 form. Select the right Real and Personal Property--Supplement to Medi-Cal Mail-In Application MC 322 version from the list and start editing it straight away!
Versions Form popularity Fillable & printable
2007 4.8 Satisfied (41 Votes)
be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
➢ Do assets affect my eligibility? Starting on January 1, 2024, assets, such as bank accounts, cash, a second vehicle, and homes, will no longer be counted when determining Medi-Cal eligibility. Income and income from assets, such as income from property, will continue to be counted.
Property Essential to Self-Support. Property (whether real or personal) used in a trade or business by the recipient, as an employee, which is essential to self-support, regardless of value, is excluded. More on countable and non-countable assets can be found in our article:Demystifying Medicaid Planning.
How long before applying for Medi-Cal can a person transfer assets? The Medi-Cal Look-Back period in California is 30 months.
Jewelry, personal vehicles, household goods, personal effects, burial plots, small burial plans, and small life insurance policies are all exempt from the Medi-Cal asset test. These items are deemed essential to daily living and are protected to meet basic needs.
Update Your Contact Information Make sure the county has your current name, mailing address, phone number, email address, or other contact information if it has changed. If your information has changed, you can update it online at benefitscal.com, or by calling 1-866-613-3777 (TTY) 1-800-660-4026.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more
ccpa2
pci-dss
gdpr-compliance
hipaa
soc-compliance