Form CCFRM604 Application for Health Insurance - California

Form CCFRM604 Application for Health Insurance - California

What Is Form CCFRM604?

This is a legal form that was released by the Covered California - 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 CCFRM604?
A: Form CCFRM604 is the application for health insurance in California.

Q: Who can use form CCFRM604?
A: Form CCFRM604 can be used by individuals who want to apply for health insurance in California.

Q: What information is required on form CCFRM604?
A: Form CCFRM604 requires personal information, income details, and household information.

Q: What is the deadline for submitting form CCFRM604?
A: The deadline for submitting form CCFRM604 may vary, so it's best to check the instructions provided with the form.

Q: Can I apply for health insurance in California without using form CCFRM604?
A: No, form CCFRM604 is required for applying for health insurance in California.

Q: Are there any fees associated with submitting form CCFRM604?
A: No, there are no fees associated with submitting form CCFRM604.

Q: What happens after submitting form CCFRM604?
A: After submitting form CCFRM604, your application will be reviewed and you will be notified about your eligibility for health insurance in California.

Q: Is there any assistance available for filling out form CCFRM604?
A: Yes, you can receive assistance in filling out form CCFRM604 from the California Department of Health Care Services or certified enrollment counselors.

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Form Details:

  • Released on November 1, 2013;
  • The latest edition provided by the Covered California;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CCFRM604 by clicking the link below or browse more documents and templates provided by the Covered California.

Download Form CCFRM604 Application for Health Insurance - California

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