Form Mc 325 - Request For Transitional Medi-Cal (Tmc) Or Four Month Continuing Medi-Cal Page 2

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TRANSITIONAL MEDI-CAL (TMC)
TMC May Provide You and Your Family with
FREE Continued Medical Coverage For Up To 12 Months.
If you:
Get a job, or
Get more money from your job, or
Get child or spousal support,
tell your worker right away or complete the back of this form and mail
it to your worker. You may still be eligible for no-cost Medi-Cal. Your
worker will determine whether your Medi-Cal health coverage can
continue.
Health care is important for you and your family. Receiving Medi-Cal
does not affect your CalWORKs time limits.
If you can’t read this notice, ask your worker for a translation.
Spanish:
Si no puede leer esta notificación, pídale a su trabajador que se la traduzca.
Cambodian:
Chinese:
Russian:
Vietnamese:
MC 325 (05/07)

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