We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Medi-cal Benefits Identification Card

Get Medi-cal Benefits Identification Card

Front Back Possessing a Medi-Cal BIC or PHC ID Card does not guarantee eligibility. Providers must continue to verify eligibility. Verify eligibility on the PHC Online eEligibility Online System on our Website at www. partnershiphp.org or by calling us at 800-557-5471. Medi-cal.ca.gov/pubsdoco/newsroom/newsroom2473701. asp Following are examples of both cards. Former Design New Design Both Benefits Identification Cards should be accepted by providers. PHC also issues ID Cards to members that lists their Primary Care Provider PCP and other information related to PHC. There are no plans to provide the new card design to the entire Medi-Cal population. Existing cards will not be replaced all at once but over time will be replaced. DHCS has issued a Provider Bulletin and Newsflash informing providers of this change at http //files. medi-cal.ca.gov/pubsdoco/newsroom/newsroom2473701. asp Following are examples of both cards. Former Design New Design Both Benefits Identification Cards should ....

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

Tips on how to fill out, edit and sign Medi-Cal Benefits Identification Card online

How to fill out and sign Medi-Cal Benefits Identification Card online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

Choosing a legal expert, creating a scheduled appointment and going to the business office for a private meeting makes doing a Medi-Cal Benefits Identification Card from beginning to end tiring. US Legal Forms enables you to quickly generate legally-compliant papers according to pre-built web-based samples.

Prepare your docs within a few minutes using our easy step-by-step guide:

  1. Get the Medi-Cal Benefits Identification Card you need.
  2. Open it with online editor and begin adjusting.
  3. Fill out the blank areas; engaged parties names, addresses and phone numbers etc.
  4. Change the blanks with exclusive fillable areas.
  5. Put the date and place your e-signature.
  6. Simply click Done after twice-checking all the data.
  7. Download the ready-produced papers to your system or print it out like a hard copy.

Quickly generate a Medi-Cal Benefits Identification Card without having to involve professionals. There are already more than 3 million customers taking advantage of our unique catalogue of legal forms. Join us today and get access to the top library of online blanks. Test it yourself!

How to edit Medi-Cal Benefits Identification Card: customize forms online

Forget an old-fashioned paper-based way of executing Medi-Cal Benefits Identification Card. Get the document filled out and signed in minutes with our professional online editor.

Are you challenged to modify and fill out Medi-Cal Benefits Identification Card? With a robust editor like ours, you can complete this in mere minutes without having to print and scan documents over and over again. We provide completely editable and straightforward document templates that will become a starting point and help you fill out the necessary form online.

All files, by default, include fillable fields you can execute as soon as you open the template. However, if you need to polish the existing content of the form or insert a new one, you can choose from a number of editing and annotation tools. Highlight, blackout, and comment on the document; add checkmarks, lines, text boxes, graphics and notes, and comments. Moreover, you can swiftly certify the template with a legally-binding signature. The completed form can be shared with others, stored, sent to external apps, or converted into any other format.

You’ll never make a wrong decision using our web-based solution to execute Medi-Cal Benefits Identification Card because it's:

  • Effortless to set up and utilize, even for those who haven’t filled the documents electronically before.
  • Powerful enough to accommodate various editing needs and document types.
  • Safe and secure, making your editing experience protected every time.
  • Available across different operating systems, making it stress-free to complete the document from just about anywhere.
  • Capable of generating forms based on ready-drafted templates.
  • Friendly to various document formats: PDF, DOC, DOCX, PPT and JPEG etc.

Don't spend time completing your Medi-Cal Benefits Identification Card obsolete way - with pen and paper. Use our feature-rich solution instead. It provides you with a comprehensive suite of editing tools, built-in eSignature capabilities, and convenience. What makes it stand out is the team collaboration options - you can work together on documents with anyone, build a well-organized document approval flow from A to Z, and a lot more. Try our online tool and get the best value for your money!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Important Information About Your Medi-Cal Benefits...
You will soon get a Medi-Cal identification card called a Benefits Identification Card, or...
Learn more
Medi-Cal Insurance Card for Merced County Alliance...
When you first become eligible for Medi-Cal, you will get a plastic Medi-Cal card from...
Learn more
CalAIM Proposal_10.28.19 - DHCS - CA.gov
Oct 28, 2019 — Identifying and Managing Member Risk and Need through Whole Person Care...
Learn more

Related links form

For Graduate Students On Contract DTR Handbook - University Of Denver 2012-13 Budget Adjustment Form - University Of Denver University Of Denver Club Sports Program Parental Permission Form ...

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

The Medi-Cal Member's beneficiary ID number. or. The last 4 digits of the Member's Social Security Number. And the Member's date of birth (2 digit month and 4-digit year) i.e. 12/1961.

Lost or stolen Medi-Cal Beneficiary Identification Cards (BIC): If you have just lost your BIC card, contact your local county worker for a replacement. ... The California Medical Board: (800) 430-4263. Medi-Cal Managed Care Ombudsman: (888) 452-8609. Medi-Cal Billing: (800) 541-5555.

When you apply and are approved for Medi-Cal services, you are issued a BIC card, which is mailed to you. To access your BIC card if it is lost or stolen, you must contact your Medi-Cal case manager. Gain access to a new medical BIC card by contacting your welfare case manager at your local welfare department.

When you apply and are approved for Medi-Cal services, you are issued a BIC card, which is mailed to you. To access your BIC card if it is lost or stolen, you must contact your Medi-Cal case manager. Gain access to a new medical BIC card by contacting your welfare case manager at your local welfare department.

Call Medi-Cal Directly You can also check on your Medi-Cal status by calling the Medi-Cal hotline at (800) 541-5555. If you're outside of California, call (916) 636-1980.

Online: Apply online at www.CoveredCA.com . Applications are securely transferred directly to your local county social services office, since Medi-Cal is provided at the county level.

You have now received or will shortly receive a plastic Benefits Identification Card (BIC). This BIC is used to verify your eligibility for Medi-Cal benefits, allowing your Medi-Cal providers to bill for your medical and/or dental care.

The Department of Health Care Services (DHCS) issues a plastic Benefits Identification Card (BIC) to each Medi-Cal recipient. It is the provider's responsibility to verify that the person is eligible for services and is the individual to whom the card was issued.

The Medi-Cal Member's beneficiary ID number. or. The last 4 digits of the Member's Social Security Number. And the Member's date of birth (2 digit month and 4-digit year) i.e. 12/1961.

You can access your member services online through your plan's website and the Covered California website. Each service manages different aspects of your coverage. Also, your local county office will take care of specific parts of your Medi-Cal membership.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Medi-Cal Benefits Identification Card
Get form
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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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
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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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