DHCS yuav tsis nrhiav kev them nyiaj rov qab yog tias tus neeg tau txais txiaj ntsig Medi-Cal muaj txoj sia nyob los ntawm tus menyuam uas dig muag lossis xiam oob khab raws li lub ntsiab lus ntawm Tsoom Fwv Teb Chaws Txoj Cai Xaus Saus nyob rau hnub ntawm daim ntawv thov nyiaj rov qab. Txawm li cas los xij, yog tias tus menyuam tseem muaj txoj sia nyob tsis muaj kev pov thawj ntawm kev xiam oob khab lossis qhov muag tsis pom los ntawm Lub Chaw Saib Xyuas Kev Nyab Xeeb Kev Nyab Xeeb, kev thov kev txiav txim siab kev tsis taus tuaj yeem raug xa mus rau DHCS.​​ 

Cov ntaub ntawv hauv qab no yuav tsum tau ua kom tiav thiab xa tuaj tsis pub dhau 60 hnub ntawm kev thov mus rau Lub Tsev Haujlwm Saib Xyuas Kev Ruaj Ntseg ntawm qhov chaw nyob hauv qab no. Thov nco ntsoov tias los ntawm kev xa cov ntaub ntawv no koj tsis tau thov rau Social Security Disability cov nyiaj pab.  Daim ntawv thov yog siv rau lub hom phiaj rov qab vaj tsev nkaus xwb.​​ 

MC 223 – Applicant’s Supplemental Statement of Facts for Medi-Cal
MC 220 – Authorization for Release of Information
DHCS 6249 – Appointment of Representative – Estate Recovery​​ 

Tsoom Fwv Teb Chaws thiab Lub Xeev Txoj Cai Tswj Xyuas Vaj Tse Rov Qab.​​ 

Cov ntaub ntawv tiv tauj​​ 

Chaw nyob xa ntawv rau kev sau ntawv:​​ 

Department of Health Care Services​​ 

Qhov Kev Pabcuam Rov Qab Av, MS 4720​​ 

PO Box 997425​​ 

Sacramento, CA 95899-7425​​ 

Rov qab mus rau nplooj ntawv Estate Recovery​​ 

Rov qab mus rau  TPLRD Home Page​​