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State of California – Health and Human Services Agency

Department of Health Care Services

Cov Puavpheej Uas Qhia Tias Yog Neeg Amelikas thiab Yog Leejtwg Tiag

Cov Kev Samfwm Tshiab rau Cov Neeg Uas Tau Txais Medi-Cal

Uas Yog Neeg Amelikas lossis Yog Neeg Ntawm Lub Tebchaws No

Ib tsab kevcai tshiab hais tias yuav luag txhua tus neeg uas thov Medi-Cal uas yog neeg Amelikas lossis neeg ntawm lub

tebchaws no yuavtsum tau muaj tej puavpheej uas qhia tias nws yog neeg Amelikas tiag thiab puavpheej qhia tias nws yog

leejtwg tiag. Nyeem cov hauv qab no saib tsab kevcai no puas hais txog koj.

Yog koj tsis yog ib tus neeg Amelikas, tsab kevcai no tsis hais txog koj.

Tsab kevcai tshiab no tsis hais txog cov neeg uas yog neeg Amelikas lossis yog neeg

Tebchaws no uas hais hauv qab no:

• Tus neeg uas tau txais: – Nyiaj Xiam Oob-qhab (SSI)

– Medicare

– Nyiaj Fajseeb Raug Mob Social Security (SSDI)

– Nyiaj Laus thiab Nyiaj Tus Txiv/Pojniam Tuag (RSI – Title II)

thiab nws mob ua tsis tau haujlwm

• Tus neeg uas tsis tau muaj 21 xyoos thiab tuaj thov Kev Khomob Tsis Qhia Niamtxiv

(Minor Consent Services)

• Cov menyuam mosliab uas yug los ntawm cov pojniam uas tau txais Medi-Cal

• Cov menyuam uas raug luag coj mus tu (Foster Care), tau txais Adoption Assistance, lossis Kin-GAP

• Cov menyuam mosliab uas nyob hauv Abandoned Baby Program

• Cov neeg uas tau txais CalWORKs

Kuv yuav mus muab cov puavpheej uas qhia tias kuv

Yog kuv tsis yog ib tus li cov neeg uas hais los saumtoj

yog neeg Amelikas licas?

no nev?

Yog koj yug rau hauv lub xeev Kalifonias, tej zaum lub

Yog koj yog ib tus neeg Amelikas lossis neeg ntawm lub

county yuav mus yuav tau koj daim ntawv yug. (Daim

tebchaws no, koj yuavtsum tau muaj puavpheej uas qhia

ntawv yug yog ib yam puavpheej uas qhia tias koj yog

tias koj yog neeg Amelikas thiab yog leejtwg tiag koj thiaj

neeg Amelikas.)

yuav tau txais Medi-Cal mus ntxiv. (Xyuas nplooj 3 txog cov

uas luag txais los ua puavpheej qhia tias koj yog neeg

Ua daim Ntawv Thov Ntawv Yug hauv Kalifonias rau lub

Amelikas thiab yog leejtwg tiag.)

county pab mus yuav koj daim ntawv yug. Tomqab ntawd

muab xa mus lossis nqa mus rau lub chaw pabcuam

Cov neeg ntawm lub tebchaws no yog suav cov neeg

pejxeem hauv koj lub nroog. Yog tias lawv nrhiav tsis tau

uas yug hauv American Samoa (suav Swains Island)

koj daim ntawv yug, koj yuav tau muab lwm yam puavpheej

thiab tuaj hauv cov Koog Povtxwv Northern Mariana

uas qhia tias koj yog neeg Amelikas. Xyuas nplooj 3 txog

Islands tuaj.

cov uas luag txais los ua puavpheej qhia tias koj yog

neeg Amelikas.

Yog tias kuv TSIS yog ib tus neeg Amelikas nev?

Nug lub county saib koj yuav muab yam puavpheej uas

Yog tias koj tsis yog ib tus neeg Amelikas lossis neeg

qhia tias koj yog neeg Amelikas licas yog koj tsis yog yug

ntawm lub tebchaws no, koj yuav tau muab cov ntaub

rau hauv lub xeev Kalifonias. Hu mus nug lub county saib

ntawv li qub tuaj xwb. Nws tsis tau muaj dabtsi hloov.

lawv puas tau nrhiav tau koj daim ntawv yug uantej koj yuav

mus them rau ib daim ntawv yug.

Kuv yuav tau txais kev khomob ntev npaum licas ntxiv?

Koj tseem yuav tau txais Medi-Cal mus ntxiv yog koj muaj

lwm yam raws li luag tus qauv thiab luag xav tau lawm thiab

koj tabtom sibzog nrhiav cov puapheej uas qhia tias koj yog

neeg Amelikas tiag thiab yog leejtwg tiag. Koj yuavtsum tau

qhia rau koj tus neeg tuav ntaub ntawv tias koj tabtom

nrhiav cov puavpheej ntawd.

DHCS 0002 (01/08) – Hmong

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Form Dhcs 0002 - Proof Of Citizenship And Identity (Hmong) - Health And Human Services Agency

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