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How to appoint a representative Download and fill out a form. Call the Marketplace appeals Center at 1-855-231-1751 to ask us to mail you the form. Write a letter. It must include: Your name, address, and phone number. Your appeal number (if you have one) A statement appointing someone as your representative.
Mail the form to address Access, PO Box 85027, San Diego, CA 92186. Please include the case number on the form when doing so. The form will be scanned into the system and a representative will contact you.
MC 382 (6/18) Use this form to appoint an individual or organization as your Medi-Cal authorized representative. Your authorized representative may act for you on all duties related to your Medi-Cal eligibility and enrollment. Or, you may also limit duties. You may cancel or change this appointment at any time.
An authorized representative is an individual authorized under State or other applicable law to act on behalf of a beneficiary or other party involved in the appeal. Authorized representatives have all of the rights and responsibilities of a beneficiary or party, as applicable, throughout the appeals process.
An authorized representative is not always needed but it should be highly considered if the individual is mentally impaired or disabled, or if there are any incompetency in language. In these cases, it is highly advised to appoint an authorized representative.
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People also ask

To be eligible for California Medicaid, you must be a resident of the state of California, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.
Someone who you choose to act on your behalf with the Marketplace, like a family member or other trusted person. Some authorized representatives may have legal authority to act on your behalf.
Formally, one cannot transfer Medicaid from state to state. However, with careful planning one can gain eligibility in their new state without a lapse in benefits. The US federal government establishes parameters for the Medicaid program.
An authorized representative is not always needed but it should be highly considered if the individual is mentally impaired or disabled, or if there are any incompetency in language. In these cases, it is highly advised to appoint an authorized representative.
Yes. There is no limit to how many Authorized Representatives you can have, but you must submit a separate form for each person you appoint as an Authorized Representative.

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