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  • Diabetes Smart Add/remove Form - Cencal Health

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E fulfillment of a prescription for a diabetic medication. Please note: Removing a member from your SMART eligibility list removes them completely from the Diabetes SMART program. In addition, this form is not a substitute for a Request for Reassignment from a Case Management List. Member Eligibility questions for all CenCal Health programs can be directed to (877) 814-1861. PCP Name PCP Phone Person Completing Form Date of Request Member s Name Member s Phone Member ID# Member s DO.

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CenCal Health offers a program called the Health Initiative (Medi-Cal) for low income residents of San Luis Obispo and Santa Barbara Counties. Please note that CenCal Health does not determine eligibility for Covered California or Medi-Cal.

Vision services that include eye examinations and glasses for children 20 years of age and under are a covered benefit and provided to your children through CenCal Health every two years.

What if I need emergency or urgent care? Emergency services are covered any time you are inside or outside of the service area (Santa Barbara or San Luis Obispo Counties) and you believe you or your child need medical care immediately. Go to the nearest emergency room or call 911.

CenCal Health has a dental liaison available to Medi-Cal dental providers to assist with referring the member to other covered services, which include but are not limited to laboratory services, pre-admission physical examinations required for admission to an outpatient surgical service center, or an inpatient ...

CenCal HEALTH is the Medi-Cal Managed Care Health Plan for Santa Barbara and San Luis Obispo Counties for low income residents.

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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