Form DHCS6209 Medi-Cal Supplemental Changes - California

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Form DHCS6209 Medi-Cal Supplemental Changes - California

What Is Form DHCS6209?

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 DHCS6209?
A: Form DHCS6209 is a Medi-Cal Supplemental Changes form used in California.

Q: What is Medi-Cal?
A: Medi-Cal is California's Medicaid program that provides free or low-cost health coverage to eligible individuals.

Q: What are Medi-Cal Supplemental Changes?
A: Medi-Cal Supplemental Changes refer to any updates or revisions made to a Medi-Cal application or enrollment.

Q: Who needs to complete Form DHCS6209?
A: Form DHCS6209 needs to be completed by Medi-Cal beneficiaries or their authorized representatives when there are changes to their information.

Q: What kind of changes can be reported on Form DHCS6209?
A: Form DHCS6209 can be used to report changes in address, income, household composition, and other relevant information.

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Form Details:

  • Released on May 1, 2021;
  • 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 fillable version of Form DHCS6209 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form DHCS6209 Medi-Cal Supplemental Changes - California

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