Get the free newborn referral form - dhcs ca

Department of Health Care Services State of California Health and Human Services Agency NEWBORN REFERRAL (PLEASE USE INK AND PRESS FIRMLY.) The Newborn Referral Form is used to assist a Medical eligible

How to fill out newborn referral form

How to fill out medi cal newborn referral:

1. Obtain the necessary referral form from your healthcare provider or insurance company.
2. Fill out the top section of the form with your child's personal information, such as their name, date of birth, and social security number.
3. Provide your own contact information in the designated fields.
4. Ensure that the referring healthcare provider fills out their section on the form accurately, including their name, contact information, and reason for referral.
5. If there are any supporting documents required, make sure to attach them to the form.
6. Review the completed form for any errors or missing information before submitting it.

Who needs medi cal newborn referral:

1. Parents or legal guardians of a newborn who want to enroll their child in Medi-Cal, a government-funded healthcare program in California.
2. Healthcare providers who have assessed the newborn and believe that they require the benefits and services provided by Medi-Cal may also need a referral to initiate the enrollment process.
3. It is important to check with the specific requirements of your state's Medicaid program to determine if a newborn referral is needed.

People Also Ask about

How do I add my newborn to Medi-Cal California?

Complete the Infant Registration Form​ and send it to MCAP within 30 days after your delivery. Fax this information to 1-888-889-9238, or send this information to MCAP at the address printed on the form. If you do not receive the Infant Registration Form, call 1-800-433-2611.

How to submit form MC 382?

You may give this form to your local county office in person or by mail, phone or electronically.

What does Medi-Cal cover?

Medi-Cal covers most medically necessary care. This includes doctor and dentist appointments, prescription drugs, vision care, family planning, mental health care, and drug or alcohol treatment. Medi-Cal also covers transportation to these services.

Does Medi-Cal cover newborns?

If you are enrolled in MCAP, your baby has eligibility for coverage in the Medi-Cal Access Infant Program for up to two years, unless your baby is enrolled in employer sponsored insurance or no-cost Medi-Cal or your income no longer qualifies on your infant's first birthday.

Do all babies qualify for Medi-Cal?

Children under 19 years of age are eligible for full-scope Medi-Cal benefits regardless of immigration status, as long as they meet the income standards.

Does insurance cover having a baby in California?

Pregnancy and childbirth services are covered under all plans available through Covered California and Medi-Cal. Having a baby means you qualify for special enrollment – in other words, you can enroll through Covered California even if it's outside the normal open-enrollment period.

How do I add my newborn to Medi-Cal?

Complete the Infant Registration Form​ and send it to MCAP within 30 days after your delivery. Fax this information to 1-888-889-9238, or send this information to MCAP at the address printed on the form. If you do not receive the Infant Registration Form, call 1-800-433-2611.

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What is newborn referral form?

A newborn referral form is a document used by healthcare providers to refer newborns for further medical evaluation or treatment services.

Who is required to file newborn referral form?

Healthcare providers, such as pediatricians or obstetricians, are typically required to file the newborn referral form when they identify a need for specialized care for a newborn.

How to fill out newborn referral form?

To fill out the newborn referral form, complete all required sections with accurate information about the newborn, including personal details, medical history, and the specific reasons for the referral.

What is the purpose of newborn referral form?

The purpose of the newborn referral form is to ensure that newborns receive appropriate and timely care by referring them to specialists when needed.

What information must be reported on newborn referral form?

The newborn referral form must typically include the newborn's name, date of birth, medical history, reasons for referral, and the healthcare provider's contact information.