PDF
Word
Form MC604 MDV Doctor's Verification for Home and Community Based Services Under Spousal Impoverishment Provisions - California (Thai)
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 Thai. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form MC604 MDV?
A: Form MC604 MDV is a doctor's verification form for Home and Community Based Services under Spousal Impoverishment Provisions in California.
Q: Who is this form for?
A: This form is for individuals who are applying for Home and Community Based Services in California and need to provide verification from a doctor.
Q: What are Home and Community Based Services?
A: Home and Community Based Services are services provided to individuals who need assistance with daily activities to enable them to live in their own homes and communities.
Q: What are Spousal Impoverishment Provisions?
A: Spousal Impoverishment Provisions are rules that help protect the income and resources of a spouse when the other spouse needs long-term care services.
Q: Why is doctor's verification required?
A: Doctor's verification is required to confirm the medical need for Home and Community Based Services and eligibility under the Spousal Impoverishment Provisions.
Q: Are there any fees associated with this form?
A: No, there are no fees associated with Form MC604 MDV.
Q: Who should complete the form?
A: The form should be completed by a licensed medical doctor or other qualified healthcare professional who is familiar with the individual's medical condition.
Q: How long does it take to process the form?
A: The processing time may vary, but it is generally recommended to submit the form as soon as possible to avoid delays in receiving Home and Community Based Services.
Q: What happens after the form is submitted?
A: After the form is submitted, it will be reviewed by the California Department of Health Care Services to determine eligibility for Home and Community Based Services.
Form Details:
- Released on August 1, 2017;
- 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;
Download a fillable version of Form MC604 MDV by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form MC604 MDV Doctor's Verification for Home and Community Based Services Under Spousal Impoverishment Provisions - California (Thai)
1
2
