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Get Ca Mc 354 2007-2025

Ation 2. Old Contact Information Name (print) Name (print) Address (number, street, apt.) Address (number, street, apt.) City State ZIP code Mailing address (if different from above) City City State ZIP code State ZIP code Mailing address (if different from above) State ZIP code City Telephone number Telephone number ( ( ) 3. Your Health Plan Information ) 4. Personal Information Health plan name (print) Your date of birth Your health plan number Your Beneficiary Ide.

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How to fill out the CA MC 354 online

The CA MC 354 form is essential for updating contact information for Medi-Cal beneficiaries in California. This guide provides a step-by-step approach to filling out the form online to ensure your information is accurate and up to date.

Follow the steps to fill out the CA MC 354 form correctly.

  1. Click the ‘Get Form’ button to obtain the CA MC 354 document and open it in the online editor.
  2. Begin with section 1, 'New Contact Information'. Enter your updated name, address, city, state, and ZIP code. If there is a different mailing address, provide that information as well.
  3. In section 2, 'Old Contact Information', input your previous name, address, city, state, and ZIP code details to help the Medi-Cal office identify the changes.
  4. Proceed to section 3, 'Your Health Plan Information'. Fill in the name of your health plan, your date of birth, health plan number, and Beneficiary Identification Card (BIC) number as required.
  5. In section 4, sign and date the authorization box confirming your permission for the county Medi-Cal office to update your case file with the changes you provided.
  6. Review all entries for accuracy. Once verified, you can save your changes, download a copy of the form, print it, or share it as needed.

Complete your CA MC 354 form online to ensure your Medi-Cal information is current and accurate.

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Medicare Medi-Cal Plans Starting on January 1, 2023, Cal MediConnect members will be transitioned to MMPs, or Medi-Medi Plans. MMPs is the California-specific program name for Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (EAE D-SNPs).

Your county's social services office may contact you by mail or by phone to request paper verification if income, citizenship, and other criteria cannot be verified electronically. Receive Final Notice of Action notifying you of whether or not you can receive Medi-Cal.

If you do not report changes to your personal information right away, and then receive Medi-Cal benefits that you do not qualify for, you may have to repay DHCS. 19. You, or any family member receiving Medi-Cal, must not be getting public assistance from another state.

ing to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income.

Medi-Cal Income & Assets Limits for Eligibility April 2023 – March 2024 California Medicaid / Medi-Cal Long-Term Care Eligibility for SeniorsType of MedicaidSingleMarried (one spouse applying)Regular Medicaid / Aged Blind and Disabled$1,677 / month$195,0003 more rows • Mar 15, 2023

You have a household income under 150 percent of the federal poverty level, which is less than $19,320 for an individual and $39,750 for a family of four.

Most single individuals will qualify for Medi-Cal if there income is under $1,564 per month. Most couples will qualify if their income is under $2,196 per month. If you have disabilities, your income can be slightly higher. As of July 1, 2022, you can qualify for Medi-Cal even if you have assets.

If a Medi-Cal applicant's property/assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property/assets ing to the program rules. The Medi-Cal eligibility worker looks at how much an applicant and their family has each month.

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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
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
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
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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