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Forms and applications listed here are only a portion of those available. Visit your local MDHHS Office for forms or applications not available online. To view or print PDF files, you will need Adobe Acrobat Reader.
Covered California and Medi-Cal use the same application. For food, cash aid, and health coverage.
Treatment Authorization Forms/Guidelines Last modified date: 9/18/2023 4:07 PM Get Help in Your Language
Michigan offers several medical assistance programs. Each program covers different groups of people and each program has different eligibility requirements. When you apply for a program, your age, income, financial resources, and other information will be used to determine if you are eligible.
medical needs INSTRUCTIONS: To be completed by a physician, physician assistant, nurse practitioner, clinical nurse specialist, physical or occupation therapist.
PDF fill-and-print forms may be completed online and printed to hardcopy to be signed and mailed in or submitted in person to an eligibility worker for processing. Medi-Cal Printable Application: Medi-Cal Single Streamlined Application
With just one application, you’ll find out if you qualify for free or low-cost health insurance, including Medi-Cal. The state of California created Covered CaliforniaTM to help you and your family get health insurance. Having health insurance can give you peace of mind and help make it possible for you to stay healthy.