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Click ‘Get Form’ to open the ccis redetermination form in the editor.
Review the Redetermination Summary Form carefully. If there are no changes, simply sign the form and provide proof of pay for 4 weeks out of the past 6 weeks.
If there are changes, note them directly on the form. Ensure you sign it and attach proof of these changes along with your pay documentation.
For additional family members, fill in their details in the extra rows provided at the end of each section.
Once completed, return all pages of the form to CCIS as instructed. You can also save your progress and come back later if needed.

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What is redetermination form?

Medicaid Redetermination (also known as Medicaid Recertification, or Medicaid Renewal) is the regular eligibility review that each states Medicaid agency conducts to determine whether beneficiaries still qualify for Medicaid or Childrens Health Insurance Plan (CHIP) coverage.

How do I submit my Medi-Cal certification to EDD?

3:25 36:18 Lets begin with the first section of the medical renewal. Form time to renew benefits.MoreLets begin with the first section of the medical renewal. Form time to renew benefits.

How do I submit a medical redetermination form?

Requested information can be submitted by mail, in person, online, or phone. Members can submit information online by logging in or creating an online account at benefitscal.com. To submit information by phone, members can call DPSS at 1-866-613-3777 Monday Friday from 7:30 a.m. 6:30 p.m. (excluding holidays).

How do I submit my Medi-Cal redetermination online?

Members can submit information online by logging in or creating an online account at benefitscal.com. To submit information by phone, members can call DPSS at 1-866-613-3777 Monday Friday from 7:30 a.m. 6:30 p.m. (excluding holidays). How can Medi-Cal members receive alerts on their Medi-Cal case?