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Form DHCS9119 Release of Information - Health Insurance Premium Payment (HIPP) Program - California
What Is Form DHCS9119?
This is a legal form that was released by the California Department of Health Care Services - 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 DHCS9119 Release of Information?
A: DHCS9119 Release of Information is a form used for the Health Insurance Premium Payment (HIPP) Program in California.
Q: What is the Health Insurance Premium Payment (HIPP) Program?
A: The Health Insurance Premium Payment (HIPP) Program is a program in California that helps eligible individuals and families pay for health insurance premiums.
Q: Why do I need to fill out the DHCS9119 Release of Information form?
A: You need to fill out the DHCS9119 Release of Information form to authorize the release of certain health insurance information to the HIPP Program.
Q: Who is eligible for the HIPP Program?
A: Eligibility for the HIPP Program varies based on income and other factors. It is best to contact the California Department of Health Care Services (DHCS) for specific eligibility criteria.
Q: What happens after I submit the DHCS9119 Release of Information form?
A: After you submit the DHCS9119 Release of Information form, the HIPP Program will review your application and determine if you are eligible for assistance.
Q: How long does it take to process the DHCS9119 Release of Information form?
A: Processing times may vary, but it typically takes several weeks for the HIPP Program to review and process the DHCS9119 Release of Information form.
Q: Can I appeal if my application for the HIPP Program is denied?
A: Yes, if your application for the HIPP Program is denied, you have the right to appeal the decision. Contact the California Department of Health Care Services (DHCS) for more information on the appeals process.
Q: Is the HIPP Program available in all counties in California?
A: The availability of the HIPP Program may vary by county. It is recommended to contact the California Department of Health Care Services (DHCS) for information on whether the program is available in your county.
Form Details:
- Released on April 1, 2023;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DHCS9119 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
