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MEDICAL / HEALTHY KIDS FORMULARY GUIDE* 2015PHARMACY TAR SUBMISSION Providers submitting POS claims through Impact: Online TAR: https://parx.partnershiphp.org (FAX if online is unavailable: 7074197900)Providers

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How to fill out medi-cal

How to Fill Out Medi-Cal:

01

Gather necessary documents: Before starting the application process, gather important documents such as proof of identity (e.g., driver's license, passport), proof of income (e.g., pay stubs, tax returns), proof of residency (e.g., utility bills, lease agreement), and any relevant health insurance information.

02

Access the application: There are multiple ways to access the Medi-Cal application. You can apply online through Covered California's website, by phone, by mail, or in person at your local county welfare department. Choose the method that suits you best.

03

Complete the application form: Provide accurate and detailed information in the application form. This includes personal details like name, address, date of birth, and social security number. Answer all questions related to income, household size, citizenship status, and any other supporting details.

04

Provide required supporting documentation: Depending on your specific situation, the application may require you to submit additional documents. For instance, if you are applying for a child, you might need to provide proof of age, immunization records, and school enrollment information. Ensure you attach all requested documents.

05

Submit the application: After filling out the application and gathering the necessary documentation, review everything to make sure it is complete and accurate. Submit the application as instructed by the application method you have chosen. Keep a copy of the application and any supporting documents for your records.

Who Needs Medi-Cal:

01

Individuals with low income: Medi-Cal is primarily designed for individuals and families with low income who cannot afford private health insurance. It provides essential health coverage, including doctor visits, hospital care, prescription medications, and preventive services, at little to no cost.

02

Pregnant women and families with children: Pregnant women, infants, and children may qualify for Medi-Cal based on income and family size. This can help ensure that infants and children receive proper healthcare from an early age and pregnant women receive necessary prenatal care.

03

Elderly and disabled individuals: Medi-Cal also provides support for elderly individuals and those with disabilities who meet the income and asset requirements. This population can access long-term care services, in-home supportive services, and nursing home care.

04

Individuals with specific health needs: Medi-Cal may be available to individuals with specific health conditions or disabilities who require specialized care and treatment. These individuals may qualify for Medi-Cal through specific programs intended to address their unique healthcare needs.

Note: Eligibility for Medi-Cal may vary based on factors such as income, family size, age, and disability status. It is recommended to consult with an eligibility specialist at your local county welfare department or access the Medi-Cal website for detailed information and to understand the eligibility requirements specific to your situation.

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What is medi-cal?

Medi-Cal is California's Medicaid program that provides free or low-cost health coverage for eligible individuals and families.

Who is required to file medi-cal?

Individuals and families with low income or disabilities may be required to file for Medi-Cal in order to receive health coverage.

How to fill out medi-cal?

To apply for Medi-Cal, you can fill out an application online, by mail, or in person at your local county social services office.

What is the purpose of medi-cal?

The purpose of Medi-Cal is to ensure that low-income individuals and families have access to necessary health care services.

What information must be reported on medi-cal?

You must report your income, household size, assets, and any other relevant information to determine your eligibility for Medi-Cal.

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