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 Russian. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form MC381?
A: Form MC381 is a Cancellation or Change to a Medi-Cal Authorized Representative Appointment form.
Q: What is Medi-Cal?
A: Medi-Cal is California's Medicaid program that provides free or low-cost health coverage to eligible individuals.
Q: What is an authorized representative in Medi-Cal?
A: An authorized representative is a person who is able to act on behalf of a Medi-Cal beneficiary, such as assisting with the application or managing their Medi-Cal benefits.
Q: What can be done with Form MC381?
A: Form MC381 can be used to cancel or make changes to a Medi-Cal authorized representative appointment.
Q: Who can use Form MC381?
A: This form can be used by Medi-Cal beneficiaries or their authorized representative to cancel or change the appointment of an authorized representative in California.
Q: Is there a specific language requirement for Form MC381?
A: This particular form is in Russian, but there may be versions available in other languages.
Q: Is there a deadline to submit Form MC381?
A: There may not be a specific deadline, but it is recommended to submit the form as soon as possible.
Q: What should I do if I need help with Form MC381?
A: If you need assistance with Form MC381, you can contact the California Department of Health Care Services (DHCS) or your local county social services office for guidance.
Form Details:
Download a fillable version of Form MC381 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.