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Get Ca Mc 354 2007-2026
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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.
- Click the ‘Get Form’ button to obtain the CA MC 354 document and open it in the online editor.
- 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.
- 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.
- 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.
- 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.
- 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.
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).