Form Dhcs 0002 - California Proof Of Citizenship And Identity (Vietnamese) - Health And Human Services Agency Page 2
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4State of California – Health and Human Services Agency
Department of Health Care Services
Neá u toâ i khoâ n g theå ñöa ra baè n g chöù n g veà quoá c tòch
Toâ i coù phaû i ñöa ra baè n g chöù n g quoá c tòch vaø caê n
hoaë c caê n cöôù c thì sao?
cöôù c moã i laà n toâ i kyù baû o hieå m laï i khoâ n g?
Quyù vò seõ coù moä t thôø i gian hôï p lyù ñeå ñöa ra baè n g
Khoâ n g. Quyù vò chæ phaû i ñöa ra chi tieá t naø y moä t laà n
chöù n g cuû a mình.
thoâ i – khi quyù vò noä p ñôn laà n ñaà u hoaë c vaø o phieâ n
taù i thaå m ñònh haø n g naê m laà n tôù i cuû a quyù vò.
Neá u quyù vò khoâ n g theå ñöa ra baè n g chöù n g cuû a mình
nhöng quyù vò tieá p tuï c hoä i ñuû taá t caû caù c tieâ u chuaå n
Luaä t naø y coù aû n h höôû n g ñeá n quyeà n lôï i Phieá u
ñieà u kieä n coø n laï i , quyù vò seõ ñöôï c chuyeå n sang höôû n g
Thöï c Phaå m , CalWORKs, hoaë c Healthy Families
quyeà n lôï i giôù i haï n . Quyeà n lôï i giôù i haï n ñaø i thoï caù c
cuû a toâ i khoâ n g?
dòch vuï caá p cöù u , lieâ n heä ñeá n thai ngheù n , vaø chaê m soù c
Khoâ n g. Ñieà u kieä n môù i veà quoá c tòch vaø caê n cöôù c chæ
daø i haï n .
aù p duï n g cho Medi-Cal maø thoâ i .
Neá u quyù vò ñöa ra baè n g chöù n g trong voø n g moä t naê m
Quyù vò coù caà n baû n chính giaá y tôø quoá c tòch vaø caê n
sau khi bò taù i thaå m ñònh, quyeà n lôï i Medi-Cal cuû a quyù
vò seõ trôû thaø n h ñaà y ñuû tính töø thaù n g quyeà n lôï i giôù i haï n
cöôù c khoâ n g?
cuû a quyù vò baé t ñaà u .
Coù . Chuù n g toâ i caà n baû n chính giaá y tôø quoá c tòch vaø caê n
cöôù c , hoaë c phoù baû n ñaõ ñöôï c cô quan caá p giaá y tôø
Neá u quyù vò coù phí toå n veà söù c khoû e trong khi ñang laá y
chöù n g nhaä n .
giaá y tôø quoá c tòch vaø caê n cöôù c , Medi-Cal coù theå thanh
toaù n caù c hoù a ñôn cuû a quyù vò. Goï i cho Ban Dòch Vuï
Toâ i coù theå göû i thö baè n g chöù n g cuû a toâ i khoâ n g?
Quyeà n Lôï i cuû a Boä Dòch Vuï Chaê m Soù c Söù c Khoû e ñeå
tìm giaû i ñaù p cho caù c thaé c maé c cuû a quyù vò:
Coù . Quaä n seõ sao chuï p vaø göû i traû laï i cho quyù vò.
(916) 403-2007.
Hoaë c , quyù vò coù theå caà m giaá y tôø cuû a mình ñeá n vaê n
phoø n g dòch vuï xaõ hoä i ñòa phöông. Yeâ u caà u hoï sao
Treû em coù phaû i ñöa ra baè n g chöù n g veà quoá c tòch vaø
chuï p giaá y tôø vaø traû laï i ngay cho quyù vò.
caê n cöôù c nhö ngöôø i lôù n khoâ n g?
Coù . Neá u con quyù vò sinh ra taï i California, nhôø quaä n
cuû a quyù vò hoû i laá y hoà sô khai sinh laø m baè n g chöù n g
quoá c tòch. Quyù vò seõ vaã n phaû i ñöa ra baè n g chöù n g veà
caê n cöôù c . Xem trang 3.
Neá u con quyù vò döôù i 16 tuoå i vaø quyù vò ñaõ ñieà n vaø kyù
ñôn xin Medi-Cal hoaë c ñôn xin chung Healthy
Families/Medi-Cal coù ñeå ngaø y sinh vaø nôi sinh cuû a
ñöù a treû , quyù vò khoâ n g caà n ñöa ra baè n g chöù n g veà caê n
cöôù c . (Ñôn coù chöõ kyù naø y laø baè n g chöù n g veà caê n cöôù c
cuû a con quyù vò.) Quyù vò vaã n phaû i ñöa ra baè n g chöù n g
veà quoá c tòch.
Neá u con quyù vò töø 16 tuoå i trôû leâ n , quyù vò caà n phaû i ñöa
ra baè n g chöù n g veà caê n cöôù c cho con quyù vò. Xem
trang 3.
DHCS 0002 (01/08) – Vietnamese
Page 2 of 4
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