Form Dhcs 0001 - California U.s. Citizens And Nationals Applying For Medi-Cal Must Show Proof Of Citizenship And Identity (Vietnamese) - Health And Human Services Agency
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4State of California – Health and Human Services Agency
Department of Health Care Services
Coâ n g Daâ n vaø Cö Daâ n Hoa Kyø Noä p Ñôn Xin Medi-Cal
Phaû i Ñöa Ra Baè n g Chöù n g veà Quoá c Tòch vaø Caê n Cöôù c
Luaä t môù i quy ñònh raè n g haà u heá t coâ n g daâ n hoaë c cö daâ n Hoa Kyø noä p ñôn xin Medi-Cal phaû i ñöa ra baè n g chöù n g quoá c
tòch vaø baè n g chöù n g caê n cöôù c . Ñoï c phaâ à n döôù i ñaâ y xem luaä t naø y coù aù p duï n g cho quyù vò khoâ n g.
Neá u quyù vò khoâ n g laø coâ n g daâ n Hoa Kyø , luaä t naø y khoâ n g aù p duï n g cho quyù vò.
Luaä t môù i naø y khoâ n g aù p duï n g ñoá i vôù i coâ n g daâ n vaø cö daâ n Hoa Kyø thuoä c baá t cöù dieä n naø o sau ñaâ y :
• Baá t cöù ai coù : – Thu Nhaä p An Sinh Phuï Caá p (SSI)
– Medicare
– Baû o Hieå m An Sinh Xaõ Hoä i Veà Khuyeá t Taä t (SSDI)
– Baû o Hieå m An Sinh Xaõ Hoä i Veà Höu Trí vaø Thaâ n Quyeá n (RSI – Tieâ u Ñeà II)
treâ n caê n baû n khuyeá t taä t cuû a hoï
• Baá t cöù ai döôù i 21 tuoå i ñang xin Dòch Vuï Coù Ñoà n g YÙ Cuû a Vò Thaø n h Nieâ n
• Treû sô sinh cuû a phuï nöõ ñang höôû n g Medi-Cal
• Treû Em ñang ñöôï c Chaê m Soù c Taï m Thôø i , Hoã Trôï Nhaä n Con Nuoâ i , hoaë c Kin-GAP
• Treû sô sinh trong Chöông Trình Treû Bò Boû Rôi
•
Nhöõ n g Ngöôø i Ñang Höôû n g Quyeà n Lôï i CalWORKs
Neá u toâ i khoâ n g phaû i laø moä t trong nhöõ n g ngöôø i neâ u
Toâ i laø m theá naø o ñeå coù baè n g chöù n g veà quoá c tòch?
treâ n thì sao?
Neá u quyù vò sinh ra taï i California, quaä n coù theå laá y
ñöôï c hoà sô khai sinh cuû a quyù vò. (Hoà sô khai sinh laø
Neá u quyù vò laø coâ n g daâ n hoaë c cö daâ n Hoa Kyø , quyù vò
baè n g chöù n g quoá c tòch.)
phaû i ñöa ra baè n g chöù n g veà quoá c tòch vaø caê n cöôù c ñeå
hoä i ñuû ñieà u kieä n höôû n g Medi-Cal. (Xem trang 3 ñeå
Ñieà n maã u Ñôn Xin Hoà Sô Khai Sinh California
bieá t danh saù c h loaï i baè n g chöù n g veà quoá c tòch vaø caê n
(Request for California Birth Record) ñeå yeâ u caà u quaä n
cöôù c ñöôï c chaá p nhaä n .)
cung caá p hoà sô khai sinh cuû a quyù vò. Sau ñoù , göû i thö
hoaë c caà m maã u naø y ñeá n vaê n phoø n g dòch vuï xaõ hoä i ñòa
Quyù vò khoâ n g theå nhaä n ñaà y ñuû quyeà n lôï i Medi-Cal
phöông quyù vò. Neá u khoâ n g tìm ñöôï c hoà sô khai sinh,
cho ñeá n khi quyù vò ñöa ra baè n g chöù n g.
quyù vò seõ phaû i ñöa ra moä t baè n g chöù n g khaù c veà quoá c
Cö daâ n Hoa Kyø bao goà m caû nhöõ n g ngöôø i sinh ra taï i
tòch. Xem trang 3 ñeå bieá t danh saù c h giaá y tôø ñöôï c
Samoa thuoä c Myõ (keå caû Swains Island) vaø moä t soá
chaá p nhaä n .
ngöôø i nhaá t ñònh töø quaà n ñaû o “Commonwealth of the
Hoû i quaä n cuû a quyù vò veà caù c h laá y baè n g chöù n g quoá c
Northern Mariana Islands”.
tòch neá u quyù vò khoâ n g sinh ra taï i California. Lieâ n laï c
Neá u toâ i KHOÂ N G phaû i laø coâ n g daâ n Hoa Kyø thì sao?
vôù i quaä n ñeå xem hoï coù tìm thaá y hoà sô khai sinh ñuù n g
vôù i quyù vò chöa tröôù c khi traû tieà n ñeå laá y giaá y khai sinh.
Neá u quyù vò khoâ n g phaû i laø coâ n g daâ n hoaë c cö daâ n Hoa
Kyø , quyù vò seõ phaû i ñöa ra caù c giaá y tôø gioá n g nhö ñoø i
hoû i tröôù c ñaâ y . Khoâ n g coù gì thay ñoå i .
DHCS 0001 (01/08) – Vietnamese
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