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This version of the form is not currently in use and is provided for reference only. Download this version of
Form MC14 A
for the current year.
Form MC14 A Qualified Low-Income Medicare Beneficiary (Qmb), Specified Low-Income Medicare Beneficiary (Slmb), and Qualifying Individuals (Qi) Application - California (Hindi)
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 Hindi. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the MC14 A application?
A: The MC14 A is an application for Qualified Low-Income Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individuals (QI) programs.
Q: What are Qualified Low-Income Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individuals (QI) programs?
A: These programs help eligible individuals pay for their Medicare premiums.
Q: Who is eligible for the QMB, SLMB, and QI programs in California?
A: Eligibility varies depending on income and resources. It is best to refer to the California MC14 A application for specific eligibility criteria.
Q: Is the MC14 A application available in Hindi?
A: Yes, the MC14 A application is available in Hindi.
Form Details:
- Released on March 1, 2021;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
Download a fillable version of Form MC14 A by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form MC14 A Qualified Low-Income Medicare Beneficiary (Qmb), Specified Low-Income Medicare Beneficiary (Slmb), and Qualifying Individuals (Qi) Application - California (Hindi)
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