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Form MC176 QDWI Qualified Disabled Working Individual (Qdwi) Income Eligibility Work Sheet (Couple or Applicant With an Ineligible Spouse, With or Without a Child(Ren)) - California
What Is Form MC176 QDWI?
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. Check the official instructions before completing and submitting the form.
FAQ
Q: What is Form MC176?
A: Form MC176 is the Qualified Disabled Working Individual (QDWI) Income Eligibility Work Sheet.
Q: Who is eligible to use Form MC176?
A: This form is for couples or applicants with an ineligible spouse, with or without a child/children, residing in California.
Q: What is the purpose of Form MC176?
A: The purpose of this form is to determine the income eligibility for the Qualified Disabled Working Individual (QDWI) program.
Q: What is the Qualified Disabled Working Individual (QDWI) program?
A: The QDWI program is a program that helps low-income disabled individuals who are working and ineligible for regular Medicaid due to excess income.
Q: What information is required to complete Form MC176?
A: The form requires information related to the applicant's income and resources, as well as the spouse's income and resources if applicable.
Form Details:
- Released on May 1, 2007;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form MC176 QDWI by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form MC176 QDWI Qualified Disabled Working Individual (Qdwi) Income Eligibility Work Sheet (Couple or Applicant With an Ineligible Spouse, With or Without a Child(Ren)) - California
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