遗产追回在线表格
Thank you for visiting the Medi-Cal Estate Recovery Program online forms page. These forms have been designed to assist law firms, estate administrators, and others to submit notice to the Department of Health Care Services pursuant to Probate Code Sections 215, 9202, and 19202.
Submitting notification with an attached death certificate using one of the Notice of Death forms below satisfies these reporting requirements under State law. Please complete the appropriate form with the most current information, review it for accuracy and submit them only once. You should receive a response shortly.
在线表格
- Estate Recovery Questionnaire (Notice of Death) – Online Form
- Estate Recovery Questionnaire (Notice of Death) – Accessible PDF
- Encuesta de Medi-Cal Sobre la Recuperación del Patrimonio Sucesorio – Accesible PDF
如果您认为自己有资格获得豁免或有更多信息，可以提交以下表格。
- Estate Recovery豁免表格 – 无障碍 PDF 版本
- Case Updates and Additional Information – Online Form
- Heir Informational Sheet – Accessible PDF