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Hardship Waiver Application

DHCS will waive an applicant's proportionate share of the claim if an Application for Hardship Waiver, DHCS 6195 (05/15) is submitted within 60 days of the date on the Estate Recovery claim letter and one or more of the substantial hardship criteria apply. This criterion may be found on pages 4 & 5 of the Hardship Waiver Application. For deaths occurring on or after January 1st, 2017 there is additional hardship waiver criteria.



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Last modified on: 4/3/2018 4:34 PM