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Click ‘Get Form’ to open the SOC 295 application in the editor.
Begin by entering your Social Security Number, which is mandatory for eligibility verification. Ensure you also fill in your case number and date of application.
In Section 1, provide your full name, address, sex, and birth date. If applicable, indicate if you are a veteran or a spouse/child of a veteran.
Section 3 requires you to state whether you receive SSI/SSP benefits. If yes, provide the veteran's name and claim number.
In Section 4, indicate if you have received IHSS services previously and provide details about the last service received.
List family members living in your household in Section 5, including their names and Social Security Numbers.
Complete Section 6 regarding ethnic origin and primary language. This information is essential for service eligibility but does not affect your application status.
Finally, review all provided information for accuracy before signing the application at the bottom of the form.
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SOC 295 (9/18) - Application for In-Home Supportive Services.
What is a SOC 2298 form for IHSS?
SOC 2298 allows providers to self-docHub their living arrangements in order to claim the exclusion. SOC 2298 must be completed, signed, and returned to the State at the address provided.
What is the maximum income to qualify for IHSS?
Effective 4/1/25, the monthly income limit for the IHSS program for a single applicant is $1,801. When both spouses are applicants, there is a couple income limit of $2,433 / month.
Who can fill out SOC 873?
You must have a physician or other licensed health care professional fill out a Health Care Certification (SOC 873) form and you must return it to the county before care services can be authorized. You will be notified if your application for IHSS has been approved or denied.
How long does it take to get approved for IHSS in California?
The Assessment of Need for Protective Supervision for the In-Home Supportive Services Program form (SOC 821) should be completed by the IHSS recipients doctor or a medical professional with specialty or practice in the areas of memory, orientation, and/or judgment.
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SOC 295 (9/18) - Application for In-Home Supportive Services
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