Cmsp 219 form 2025

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MC 219 (11/15) ENG2. To verify immigration status with the Department of Homeland Security (DHS), if required. Information shared with DHS cannot be used for immigration enforcement unless you are committing fraud.
Real Property Limits Principal residence, including any appertaining buildings and land used as a home is exempt if the applicant/beneficiary lives there. Other real property with a net market value of $6,000 or less is exempt if utilization requirements are met.
Who is eligible? Adults between 21 and 64 years old. Legal residents undocumented individuals. Persons cannot be eligible for Medi-Cal, Covered California, or Medicare. Coverage is available in 35 participating counties. Applicants can qualify with: Incomes up to 300% FPL (Medi-Cal is up to 138%)
To qualify, CMSP Benefit members must: Be age 21-64. Live in one of the 35 CMSP counties. Have income up to 300% of the Federal Poverty Level (learn more about the Federal Poverty Level here)
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