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Click ‘Get Form’ to open the inter county transfer medi cal form in the editor.
Begin by filling in the 'Receiving county name and address' and 'Sending county name and address' sections. Ensure all details are accurate to avoid processing delays.
In the 'Case Name/Beneficiary Information' section, provide the case name, phone number, alternate phone number, and full address. If applicable, indicate if there is an authorized representative (AR) by selecting 'Yes' or 'No'.
Complete the 'Medi-Cal Family Budget Unit' section by listing names, aid codes, income details, and share-of-cost information for each individual included.
Fill out any additional case information required under 'Other Case Information', including court cases or annual redetermination due dates.
List all documents included in the transfer packet as specified in the form. This may include social security cards, identification, and income verifications.
Finally, provide your sending county worker's information at the bottom of the form to ensure proper communication regarding your case.
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How to transfer from Medi-Cal to Covered California?
Moving Between Covered California and Medi-Cal To report changes, call Covered California at (800) 300-1506 or sign in to your online account. You can also visit the Contact Us page to find a Licensed Insurance Agent, Certified Enrollment Counselor or county eligibility worker who can provide free help in your area.
How to apply for Medi-Cal Alameda County?
To apply for Medi-Cal by mail, you can send your Medi-Cal application to an Alameda County Social Services Agency office. To request a Medi-Cal application to mail in and Instructions booklet, please call (510) 272-3663 or 1-800-698-1118 (toll free). You may also click here for a Medi-Cal Printable Application.
How to apply for Medi-Cal Yolo County?
Apply for Medi-Cal online at benefitscal.com, in person, by phone, or by mail.
What is the easiest way to apply for Medi-Cal?
What information do I need? California Drivers License or Identification Card. Proof of California Residency. Immigration status. Birth Certificates, passports, naturalization certificates. Social Security and Medicare Card.
What is the income limit for Medi-Cal in Alameda County?
You may apply for Medi-Cal online via BenefitsCal, in person at your local offices, via mail, over the phone, or by fax. The easiest and quickest way to apply for CalWORKs, CalFresh and/or Medi-Cal is online at .benefitscal.com.
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People also ask
Can I use Medi-Cal in another county in California?
Even though Medi-Cal is a statewide program, 58 different California counties are responsible for determining Medi-Cal eligibility. When a Medi-Cal member moves between two different counties, they remain eligible for Medi-Cal. Their coverage must stay active during the move.
inter county transfer medi cal phone number
My Medi-Cal: How to Get the Health Care You Need
If you move to another California county, you can have your Medi-Cal case moved to the new county. This is called an Inter-County Transfer (ICT). You must.
The Health Certification Form will be sent to the member by the county social worker. It is important to note that the application process cannot continue
Instructions: Complete each space or box. If information does not pertain to this case, indicate with N/A. Receiving county name and address. Sending county
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