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.
Q: What is MC175-5?
A: MC175-5 is a form related to Federal Poverty Level (FPL) programs.
Q: Who is eligible for the FPL programs for pregnant women and infants?
A: Pregnant women and infants are eligible for the FPL programs.
Q: What is the income disregard for pregnant women and infants?
A: The income disregard is 200 percent for pregnant women and infants.
Q: Who is eligible for the FPL programs for children ages 1 through 5?
A: Children ages 1 through 5 are eligible for the FPL programs.
Q: What is the income disregard for children ages 1 through 5?
A: The income disregard is 133 percent for children ages 1 through 5.
Q: Who is eligible for the FPL programs for children ages 6 through 18?
A: Children ages 6 through 18 are eligible for the FPL programs.
Q: What is the income disregard for children ages 6 through 18?
A: The income disregard is 100 percent for children ages 6 through 18.
Q: Which state is this document related to?
A: This document is related to California.
Form Details:
Download a fillable version of Form MC175-5 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.