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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).
Where to mail Medi-Cal choice form?
Use this form to join or change health plans. If you need help filling out this form, call 1-800-430-4263. Mail Completed form to: California Department of Health Care Services Health Care Options Box 989009, W. Sacramento, CA 95798-9850.
Where do I send my Medi-Cal choice form?
To submit the Medi-Cal Choice Form, mail it to the California Department of Health Care Services at P.O. Box 989009, W. Sacramento, CA 95798-9850. For email submissions, refer to the official email listed on the form.
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?
What is the 3 month rule for Medi-Cal?
Retroactive Medi-Cal covers unpaid medical expenses from the three months prior to the month you apply for Medi-Cal. If you have unpaid bills from the three previous months, enter that information during the application process. If you qualify for Medi-Cal, you will also be evaluated for retroactive coverage.
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What is the doctor clinic code on Medi-Cal choice form?
Doctor/Clinic Code (To find the code number, look in the Provider Directory for the plan you are choosing. The code number is usually written under the name of your provider. It can also be called a PCP# or Provider Identification Number.) Enter the code letter for the reason you are changing your health plan.
Related links
Medi-Cal Forms - DHCS - CA.gov
Sep 18, 2023 Medi-Cal Forms. Back to Forms By Program. Individuals. Medi-Cal Eligibility Division Forms Privacy Forms Estate Recovery Forms.
Use this application to apply for anyone in your family. Apply even if you or your child already has health coverage. You could be eligible for lower-cost or
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