Form MC175-5 Federal Poverty Level (Fpl) Programs for Pregnant Women and Infants (Income Disregard, 200 Percent); Children Ages 1 Through 5 (133 Percent); and Children Ages 6 Through 18 (100 Percent) - California

Form MC175-5 Federal Poverty Level (Fpl) Programs for Pregnant Women and Infants (Income Disregard, 200 Percent); Children Ages 1 Through 5 (133 Percent); and Children Ages 6 Through 18 (100 Percent) - California

What Is Form MC175-5?

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 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.

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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 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.

Download Form MC175-5 Federal Poverty Level (Fpl) Programs for Pregnant Women and Infants (Income Disregard, 200 Percent); Children Ages 1 Through 5 (133 Percent); and Children Ages 6 Through 18 (100 Percent) - California

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  • Form MC175-5 Federal Poverty Level (Fpl) Programs for Pregnant Women and Infants (Income Disregard, 200 Percent); Children Ages 1 Through 5 (133 Percent); and Children Ages 6 Through 18 (100 Percent) - California

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  • Form MC175-5 Federal Poverty Level (Fpl) Programs for Pregnant Women and Infants (Income Disregard, 200 Percent); Children Ages 1 Through 5 (133 Percent); and Children Ages 6 Through 18 (100 Percent) - California, Page 2

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  • Form MC175-5 Federal Poverty Level (Fpl) Programs for Pregnant Women and Infants (Income Disregard, 200 Percent); Children Ages 1 Through 5 (133 Percent); and Children Ages 6 Through 18 (100 Percent) - California, Page 1
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