This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California.
The document is provided in Vietnamese. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form MC371?
A: Form MC371 is a form used in California to request additional family members to be added to a Medi-Cal plan.
Q: Who can use Form MC371?
A: Any resident of California who is eligible for Medi-Cal can use Form MC371.
Q: What is Medi-Cal?
A: Medi-Cal is a health insurance program in California that provides free or low-cost healthcare coverage to eligible individuals and families.
Q: What information do I need to complete Form MC371?
A: You will need to provide personal information about yourself and the additional family members you are requesting to be added to your Medi-Cal plan.
Q: What should I do after completing Form MC371?
A: After completing Form MC371, you should submit it to your local County Welfare Office. They will review your request and determine if you and your additional family members are eligible for Medi-Cal.
Form Details:
Download a printable version of Form MC371 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.