Form MC14 A Qualified Medicare Beneficiary (Qmb), Specified Low-Income Medicare Beneficiary (Slmb), and Qualifying Individual (Qi) Application - California (Korean)

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 Korean. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is a Qualified Medicare Beneficiary (QMB)?
A: QMB is a program that helps pay for Medicare Part A premiums, Part B premiums, deductibles, coinsurance, and copayments.

Q: What is a Specified Low-Income Medicare Beneficiary (SLMB)?
A: SLMB is a program that helps pay for Medicare Part B premiums.

Q: What is a Qualifying Individual (QI)?
A: QI is a program that helps pay for Medicare Part B premiums.

Q: Who is eligible for QMB?
A: Individuals with Medicare Part A and limited income and resources are eligible for QMB.

Q: Who is eligible for SLMB?
A: Individuals with Medicare Part A and limited income and resources are eligible for SLMB.

Q: Who is eligible for QI?
A: Individuals with Medicare Part A and limited income and resources are eligible for QI.

Q: How can I apply for QMB, SLMB, or QI?
A: You can apply for QMB, SLMB, or QI by filling out the MC14A application form and submitting it to your local Medicaid office.

Q: What documents do I need to submit with my application?
A: You will need to submit proof of identity, income, resources, and Medicare enrollment with your application.

Q: Is there a deadline to apply for QMB, SLMB, or QI?
A: There is no deadline to apply for QMB, SLMB, or QI. You can apply at any time.