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Form MC14 A Qualified Medicare Beneficiary (Qmb), Specified Low-Income Medicare Beneficiary (Slmb), and Qualifying Individual (Qi) Application - 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 a Qualified Medicare Beneficiary (QMB)?
A: A QMB is a person who meets certain income and resource limits and receives assistance with paying for their Medicare premiums, deductibles, and coinsurance.
Q: What is a Specified Low-Income Medicare Beneficiary (SLMB)?
A: An SLMB is a person who meets certain income and resource limits and receives assistance with paying for their Medicare Part B premiums.
Q: What is a Qualifying Individual (QI)?
A: A QI is a person who meets certain income and resource limits and receives assistance with paying for their Medicare Part B premiums.
Q: What is the purpose of the MC14 application?
A: The purpose of the MC14 application is to apply for the QMB, SLMB, and QI programs in California.
Q: Do I need to be a California resident to apply for QMB, SLMB, and QI programs in California?
A: Yes, you need to be a resident of California to apply for these programs in the state.
Q: What are the income and resource limits for QMB, SLMB, and QI programs?
A: The income and resource limits for these programs vary and are subject to change. It is best to refer to the MC14 application form for the most up-to-date information.
Q: What documents do I need to submit with the MC14 application?
A: The required documents may include proof of income, assets, citizenship or immigration status, and other documents as specified in the application form.
Q: How long does it take to process the MC14 application?
A: The processing time for the MC14 application may vary. It is advisable to contact the California Department of Health Care Services for more information.
Q: Are there any fees or costs associated with the MC14 application?
A: No, there are no fees or costs associated with the MC14 application.
Q: Who can I contact for more information about the QMB, SLMB, and QI programs in California?
A: You can contact the California Department of Health Care Services for more information about these programs.
Form Details:
- Released on July 1, 2022;
- 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 Medicare Beneficiary (Qmb), Specified Low-Income Medicare Beneficiary (Slmb), and Qualifying Individual (Qi) Application - California (Thai)
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