enroll in either Medi-Cal for Families or Healthy Families, print out and complete
the application below and send it to: |
Families/ Medi-Cal for Families and Pregnant Women
P.O. Box 138005
Please include with the completed application the following
1. A copy of your birth certificate or
Proof of your immigration
status or a receipt from the INS verifying that you have applied to replace your
2. Proof of deductions listed in Section 5 of the application.
Proof of California residency (or proof of income).
4. If you are pregnant,
proof of pregnancy from a doctor or medical facility.
5. Proof of income. Please
send a copy of your most recent pay stub or a copy of last year's federal income