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 Korean. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the MC0021 Medi-Cal to Healthy Families Bridging Consent Form?
A: The MC0021 Medi-Cal to Healthy Families Bridging Consent Form allows the transfer of Medi-Cal benefits to the Healthy Families Program.
Q: Who can use the MC0021 Medi-Cal to Healthy Families Bridging Consent Form?
A: This form is for residents of California who are currently receiving Medi-Cal benefits and want to transfer to the Healthy Families Program.
Q: What is the Healthy Families Program?
A: The Healthy Families Program is a state-funded health insurance program in California for low-income children and teens who do not qualify for Medi-Cal.
Q: Is the MC0021 Medi-Cal to Healthy Families Bridging Consent Form available in other languages?
A: Yes, the form is available in multiple languages, including Korean.
Form Details:
Download a fillable version of Form MC0021 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.