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Ate: Complete by entering the date or dates of review. Last CHDP Review Date and Results: Enter the date that a prior review was completed and the percent compliance. Provider Name: Enter legal name of Provider for the facility being reviewed. Address: Enter the address of the facility being reviewed. Telephone Number: Enter the primary phone number of the office. Fax: Enter the fax number of the office. Contact Person/Title: Enter the first and last name and the title of the person with whom th.

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Medi-Cal is California's Medicaid program. This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources.

​​Welcome to the California Department of Health Care Services (DHCS). DHCS is the backbone of California's health care safety net, helping millions of low-income and disabled Californians each and every day.

If you lose your card, contact your local county of social services office and ask for a new card.

Medi-Cal is California's version of the Federal Medicaid program. Medi-Cal offers no-cost and low-cost health coverage to eligible people who live in California. The Department of Health Care Services (DHCS) oversees the Medi-Cal program.

Medi-Cal premiums are required for certain children who are 1 up to 19 years of age in the Optional Targeted Low-Income Children's Program, known as the Medi-Cal for Families Program.

You will get a Form 1095-B for your Medi-Cal coverage from DHCS and you will also get a Form 1095‑A from Covered California. Each form will show the months of coverage that met the requirement for MEC for any months of coverage you got from either Medi‑Cal or Covered California.

It was formerly known as the California Department of Health Services, which was reorganized into the DHCS and the California Department of Public Health.

Medi-Cal is California's Medicaid health care program.

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© Copyright 1997-2025
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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