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  • Newborn Referral Form

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Erral Form is used to assist a Medi-Cal eligible mom to report the birth of her child(ren) to Medi-Cal. By completing the information on this form, you help the county confirm the eligibility of the newborn. Mail or fax this form to the county. County information is located on the back of this form. Any changes to the household must be reported to the county, so, turn in this information quickly. The mother may also report the birth by phone to her eligibility worker. If you are acting on behalf.

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Children under 19 years of age are eligible for full-scope Medi-Cal benefits regardless of immigration status, as long as they meet the income standards.

Are Your Kids Eligible? L.A. Care encourages families with eligible children to apply now. Call one of our many representatives for more information at 1-888-839-9909. You can apply in person at your local county human services office, or by appointment at one of our Family Resource Centers.

Complete the Infant Registration Form​ and send it to MCAP within 30 days after your delivery. Fax this information to 1-888-889-9238, or send this information to MCAP at the address printed on the form. If you do not receive the Infant Registration Form, call 1-800-433-2611.

1. Calling IEHP Member Services Department at (800) 440-IEHP (4347); or 2. Visiting the Member portal on IEHP's website at .iehp.org.

A newborn infant, or neonate, is a child under 28 days of age. During these first 28 days of life, the child is at highest risk of dying.

If you are enrolled in MCAP, your baby has eligibility for coverage in the Medi-Cal Access Infant Program for up to two years, unless your baby is enrolled in employer sponsored insurance or no-cost Medi-Cal or your income no longer qualifies on your infant's first birthday.

The newborn baby will be the patient and should be billed as baby boy/baby girl and the appropriate date of birth. Multiple births should be billed as Boy/Girl A and Boy/Girl B, and so on.

Newborn usually refers to a baby from birth to about 2 months of age. Infants can be considered children anywhere from birth to 1 year old. Baby can be used to refer to any child from birth to age 4 years old, thus encompassing newborns, infants, and toddlers.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232