Form CW103 Request for Extended or Transitional Medi-Cal - California

Form CW103 Request for Extended or Transitional Medi-Cal - California

What Is Form CW103?

This is a legal form that was released by the California Department of Social 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 Form CW103?A: Form CW103 is a request for extended or transitional Medi-Cal in California.

Q: Who can use Form CW103?A: Residents of California who are currently enrolled in Medi-Cal and want to request extended or transitional coverage can use Form CW103.

Q: What is extended Medi-Cal?A: Extended Medi-Cal provides continued coverage for individuals who would have lost their eligibility due to changes in their circumstances.

Q: What is transitional Medi-Cal?A: Transitional Medi-Cal is temporary coverage for individuals who have lost their eligibility for other Medi-Cal programs.

Q: What information do I need to provide on Form CW103?A: You will need to provide personal information, income and asset details, and information about your eligibility for other programs such as CalWORKs or Refugee Assistance.

Q: How do I submit Form CW103?A: You can submit Form CW103 by mail or in person at your local county social services agency.

Q: What happens after I submit Form CW103?A: After you submit Form CW103, your county social services agency will review your application and determine your eligibility for extended or transitional Medi-Cal.

Q: How long does it take to process Form CW103?A: The processing time for Form CW103 may vary, but you should receive a notice about your eligibility within 45 days of submitting your application.

Q: What should I do if my application for extended or transitional Medi-Cal is denied?A: If your application is denied, you may have the right to appeal the decision. Contact your local county social services agency for more information.

Q: Can I apply for extended or transitional Medi-Cal if I am already receiving regular Medi-Cal?A: Yes, you can apply for extended or transitional Medi-Cal even if you are already receiving regular Medi-Cal coverage.

ADVERTISEMENT

Form Details:

  • Released on November 1, 2009;
  • The latest edition provided by the California Department of Social 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 CW103 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the California Department of Social Services.

Download Form CW103 Request for Extended or Transitional Medi-Cal - California

4.5 of 5 (62 votes)
  • Form CW103 Request for Extended or Transitional Medi-Cal - California

    1

  • Form CW103 Request for Extended or Transitional Medi-Cal - California, Page 2

    2

  • Form CW103 Request for Extended or Transitional Medi-Cal - California, Page 1
  • Form CW103 Request for Extended or Transitional Medi-Cal - California, Page 2
Prev 1 2 Next
ADVERTISEMENT

Related Documents