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Hardship exemptions, forms, and how to apply HealthCare 2026
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- Click ‘Get Form’ to open the Hardship Waiver Application in the editor.
- Begin with Section A, where you will input the decedent’s estate information. Fill in all applicable fields such as the decedent's name and DHCS account number.
- In Section B, provide your personal information including your name, social security number, and relationship to the decedent.
- Move to Section C and check all applicable hardship waiver criteria. Ensure you attach any required documentation for each criterion selected.
- If necessary, complete Sections D and E regarding your monthly income and expenses based on the criteria you are applying under.
- Finally, sign Section G to certify that all information provided is accurate. Make sure to include your contact details.
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