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The most common form of Medi-Cal is Modified Adjusted Gross Income (MAGI) Medi-Cal. It uses tax rules to see if you qualify. Non-MAGI Medi-Cal is Medi-Cal that uses other rules to count property, household income, and size to see if you qualify.
The MC 604 IPS Evaluation for Non-MAGI Medi-Cal form requests the necessary Non-MAGI MC asset, income, and deduction information to evaluate an individual for Non-MAGI MC eligibility when such information has not been obtained through the ex-parte review process.
The document is a form from the California Department of Health Care Services requesting additional income and property information to evaluate Medi-Cal eligibility for applicants and their household members.
People Also Ask about medi cal form mc 210 MC 210 RV ENG (Rev 10/20) Other health insurance. Tell us about any health coverage that you have that is not from Medi-Cal or Medicare. Reporting other health insurance premiums that you pay may lower the income Medi-Cal uses to determine your eligibility.
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