Form MC176 P-C QMB / SLMB / QI Qualified Medicare Beneficiary (Qmb) / Specified Low-Income Medicare Beneficiary (Slmb) / Qualifying Individual (Qi) Property Work Sheet - Child - California

Form MC176 P-C QMB / SLMB / QI Qualified Medicare Beneficiary (Qmb) / Specified Low-Income Medicare Beneficiary (Slmb) / Qualifying Individual (Qi) Property Work Sheet - Child - California

What Is Form MC176 P-C QMB/SLMB/QI?

This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form MC176 P-C?
A: Form MC176 P-C is a property worksheet for QMB/SLMB/QI Qualified Medicare Beneficiary (Qmb)/ Specified Low-Income Medicare Beneficiary (Slmb)/ Qualifying Individual (Qi).

Q: What is QMB?
A: QMB stands for Qualified Medicare Beneficiary.

Q: What is SLMB?
A: SLMB stands for Specified Low-Income Medicare Beneficiary.

Q: What is QI?
A: QI stands for Qualifying Individual.

Q: What is the purpose of Form MC176 P-C?
A: The purpose of Form MC176 P-C is to provide a property worksheet for QMB/SLMB/QI.

Q: Who is eligible for QMB?
A: Individuals with limited income and resources who meet the QMB eligibility criteria are eligible for the QMB program.

Q: Who is eligible for SLMB?
A: Individuals with limited income and resources who meet the SLMB eligibility criteria are eligible for the SLMB program.

Q: Who is eligible for QI?
A: Individuals with limited income and resources who meet the QI eligibility criteria are eligible for the QI program.

Q: What is the QMB program?
A: The QMB program is a Medicaid program that helps pay Medicare premiums, deductibles, copayments, and coinsurance for eligible individuals.

Q: What is the SLMB program?
A: The SLMB program is a Medicaid program that helps pay Medicare Part B premiums for eligible individuals.

Q: What is the QI program?
A: The QI program is a Medicaid program that helps pay Medicare Part B premiums for eligible individuals.

Q: What information is needed for Form MC176 P-C?
A: Form MC176 P-C requires information about the property of the QMB/SLMB/QI applicant and their children in California.

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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 P-C QMB/SLMB/QI by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form MC176 P-C QMB / SLMB / QI Qualified Medicare Beneficiary (Qmb) / Specified Low-Income Medicare Beneficiary (Slmb) / Qualifying Individual (Qi) Property Work Sheet - Child - California

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