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 Chinese. 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 request form for adding additional family members to Medi-Cal.
Q: Who can use Form MC371?
A: This form can be used by individuals in California who are current Medi-Cal beneficiaries and want to add additional family members to their coverage.
Q: What is Medi-Cal?
A: Medi-Cal is California's Medicaid program that provides free or low-cost healthcare coverage to eligible individuals and families.
Q: What information is required on Form MC371?
A: The form requires the applicant to provide information about the additional family members being added, including their names, dates of birth, and Social Security numbers.
Q: Are there any fees associated with submitting Form MC371?
A: No, there are no fees associated with submitting Form MC371.
Q: How long does it take to process Form MC371?
A: The processing time for Form MC371 may vary, but you will receive a notice from Medi-Cal once the request has been processed.
Q: Can I add family members to my Medi-Cal coverage at any time?
A: Yes, you can add eligible family members to your Medi-Cal coverage at any time throughout the year.
Q: What if I need assistance with completing Form MC371?
A: If you need assistance with completing Form MC371, you can contact your local County Welfare Department or seek help from a certified enrollment counselor.
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.