Form Dhcs 0001 - California U.s. Citizens And Nationals Applying For Medi-Cal Must Show Proof Of Citizenship And Identity (Arabic) - Health And Human Services Agency
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4State of California – Health and Human Services Agency
Department of Health Care Services
اﻟﻣواطﻧون اﻷﻣرﻳﻛﻳون واﻟذﻳن ﻳﺣﻣﻠون اﻟﺟﻧﺳﻳﺔ اﻷﻣرﻳﻛﻳﺔ اﻟﻣﻘدﻣون طﻠب ﻟﻸﺷﺗراك
ﻳﺟب ﻋﻠﻳﻬم ﺗﻘدﻳم وﺛﻳﻘﺔ اﺛﺑﺎت اﻟﺟﻧﺳﻳﺔ واﻟﺷﺧﺻﻳﺔ
ﻓﻲ ﺑرﻧﺎﻣﺞ
Medi-Cal
ﻣن اﻟﻣواطﻧﻳن اﻷﻣرﻳﻛﻳﻳن أو ﻣن اﻟذﻳن ﻳﺣﻣﻠون اﻟﺟﻧﺳﻳﺔ
ﻗﺎﻧون ﺟدﻳد ﻳﻧص ﻋﻠﻰ ان ﻣﻌظم اﻟﻣﺳﺗﻔدﻳن ﻣن ﺑرﻧﺎﻣﺞ
Medi-Cal
.اﻷﻣرﻳﻛﻳﺔ ﻳﺟب ان ﻳﻘدﻣوا وﺛﻳﻘﺔ اﺛﺑﺎت ﺟﻧﺳﻳﺔ واﺛﺑﺎت ﺷﺧﺻﻳﺔ. اﻗرأ اﻟﺗﺎﻟﻲ ﻟﻣﻌرﻓﺔ ﻓﻳﻣﺎ اذا ﻛﺎن ﻫذا اﻟﻘﺎﻧون ﻳﻧطﺑق ﻋﻠﻳك
.إذا ﻟم ﺗﻛن اﻣرﻳﻛﻲ اﻟﺟﻧﺳﻳﺔ، ﻫذه اﻟﺗﻌدﻳﻼت ﻻ ﺗﻧطﺑق ﻋﻠﻳك
:اﻟﻘﺎﻧون اﻟﺟدﻳد ﻻ ﻳﻧطﺑق ﻋﻠﻰ اﻟﻣواطﻧﻳن أو ذوي اﻟﺟﻧﺳﻳﺔ اﻷﻣرﻳﻛﻳﺔ ﻓﻲ اﻟﺣﺎﻻت اﻟﺗﺎﻟﻳﺔ
راﺗب ﺿﻣﺎن اﺟﺗﻣﺎﻋﻲ
:• أي ﺷﺧص ﻋﻧده
(SSI)
–
ﺑرﻧﺎﻣﺞ ﻣﻳدي ﻛﻳر
Medicare
–
ﺗﺄﻣﻳن ﺿﻣﺎن اﺟﺗﻣﺎﻋﻲ ﻟﻠﻌﺟز
(SSDI)
–
.ﺑﻧﺎء ا ً ﻋﻠﻰ ﻧوع ﻋﺟزﻫم
ﺗﺄﻣﻳن ﺿﻣﺎن اﺟﺗﻣﺎﻋﻲ ﻟﻠﻣﺗﻘﺎﻋدﻳن واﻟﻌﺟزة
(RSI-Title II)
–
وﺗﻘدم ﺑطﻠب اﺳﺗﺣﻘﺎق رﻋﺎﻳﺔ ﻗﺎﺻر
• اي ﺷﺧص ﺗﺣت ﻋﻣر
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• أطﻔﺎل ﻣوﻟودﻳن ﻣن اﻣﻬﺎت ﻣﺷﺗرﻛﺎت ﺑﺑرﻧﺎﻣﺞ ﻣﻳدي ﻛﺎل
Medi-Cal
•
Kin-GAP اﻷطﻔﺎل ﻓﻲ اﻟﺮﻋﺎﻳﺔ اﻟﻤﺆﻗﺘﺔ، أو ﻣﺴﺎﻋﺪة اﻟﺘﺒﻨﻲ، أو
“• اطﻔﺎل ﻓﻲ ﺑرﻧﺎﻣﺞ ”رﻋﺎﻳﺔ اﻟطﻔل اﻟﻣﻬﺟور
• اﻟﻣﻧﺗﻔﻌﻳن ﻣن ﺑرﻧﺎﻣﺞ
CalWORKs
ﻛﻳف ﻳﻣﻛﻧﻧﻲ أن أﺣﺻل ﻋﻠﻰ وﺛﻳﻘﺔ اﺛﺑﺎت اﻟﺟﻧﺳﻳﺔ؟
ﻣﺎذا ﻟو ﻟم اﻛن واﺣد ا ً ﻣن اﻟﻣذﻛورﻳن اﻋﻼه؟
اذا ﻛﻧت ﻣوﻟود ا ً ﻓﻲ ﻛﺎﻟﻳﻔورﻧﻳﺎ، ﻳﻣﻛن ﻟﻠﻣﻘﺎطﻌﺔ اﻟﺗﻲ ﺗﺗﺑﻊ
،اذا ﻛﻧت ﻣواطن أﻣرﻳﻛﻲ أو ﺗﺣﻣل اﻟﺟﻧﺳﻳﺔ اﻷﻣرﻳﻛﻳﺔ
ﺳﺟل اﻟوﻻدة ﻫو دﻟﻳل
.ﻟﻬﺎ أن ﺗﺣﺻل ﻋﻠﻰ ﺳﺟل وﻻدﺗك
ﻳﺟب ﻋﻠﻳك ﺗزوﻳدﻧﺎ ﺑوﺛﻳﻘﺔ اﺛﺑﺎت اﻟﺟﻧﺳﻳﺔ واﻟﺷﺧﺻﻳﺔ
)
.اﺛﺑﺎت ﺟﻧﺳﻳﺔ
اﻧظر ﻓﻲ اﻟﺻﻔﺣﺔ
ﻟﻘﺑوﻟك ﺑﺑرﻧﺎﻣﺞ ﻣﻳدي ﻛﺎل
(
) .Medi-Cal
.ﻋﻠﻰ ﻗﺎﺋﻣﺔ اﻟوﺛﺎﺋق اﻟﻣﻘﺑوﻟﺔ ﻻﺛﺑﺎت اﻟﺟﻧﺳﻳﺔ واﻟﺷﺧﺻﻳﺔ
(
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اﻣﻸ ﻧﻣوذج ”طﻠب ﺳﺟل وﻻدة ﻓﻲ ﻛﺎﻟﻳﻔورﻧﻳﺎ“ ﻟﺗﻘوم
اﻟﻣﻘﺎطﻌﺔ ﺑطﻠب ﺳﺟل وﻻدﺗك. ﺛم، ارﺳل أو ﺧذ اﻟطﻠب اﻟﻰ
ﻻ ﻳﻣﻛﻧك اﻟﺣﺻول ﻋﻠﻰ ﺑرﻧﺎﻣﺞ ﺗﻐطﻳﺔ ﻛﺎﻣل ﻓﻲ ﺑرﻧﺎﻣﺞ
ﻣرﻛز اﻟﺧدﻣﺔ اﻷﺟﺗﻣﺎﻋﻳﺔ اﻟﻣﺣﻠﻲ. وإذا ﻟم ﻳﻛن ﻣن اﻟﻣﻣﻛن
.اﻟﻰ أن ﺗﻘوم ﺑﺗﻘدﻳم وﺛﻳﻘﺔ اﻷﺛﺑﺎت
Medi-Cal
.إﻳﺟﺎد ﺳﺟل وﻻدة، ﻓﺳﻳﻛون ﻋﻠﻳك ﺗوﻓﻳر إﺛﺑﺎت ﺟﻧﺳﻳﺔ آﺧر
اﻟﻣواطﻧون اﻷﻣرﻳﻛﻳون ﻳﺷﻣﻠون اﻷﺷﺧﺎص اﻟﻣوﻟودﻳن
.ﻋﻠﻰ ﻗﺎﺋﻣﺔ اﻟوﺛﺎﺋق اﻟﻣﻘﺑوﻟﺔ
اﻧظر ﻓﻲ اﻟﺻﻔﺣﺔ
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وأﺷﺧﺎص
ﺑﻣﺎ ﻓﻳﻬﺎ ﺟزﻳرة ﺳواﻳن
ﻓﻲ ﺳﺎﻣوا اﻻﻣرﻳﻛﻳﺔ
(
)
اﺳﺗﻔﺳرﻣن اﻟﻣﻘﺎطﻌﺔ اﻟﺗﺎﺑﻊ ﻟﻬﺎ ﻋن ﻛﻳﻔﻳﺔ اﻟﺣﺻول ﻋﻠﻰ
.ﻣﻌﻳﻧﻳن ﻣن ﻛوﻣﻧوﻳﻠث ﺟزر ﻣﺎرﻳﺎﻧﺎ اﻟﺷﻣﺎﻟﻳﺔ
.وﺛﻳﻘﺔ اﺛﺑﺎت اﻟﺟﻧﺳﻳﺔ اذا ﻟم ﺗﻛن ﻣوﻟودا ﻓﻲ ﻛﺎﻟﻳﻔورﻧﻳﺎ
راﺟﻊ اﻟﻣﻘﺎطﻌﺔ ﻟﻣﻌرﻓﺔ ﻓﻳﻣﺎ اذا ﻗد اذا ﺗم إﻳﺟﺎد ﺳﺟل وﻻدة
.ﻳﻧطﺑق ﻋﻠﻳك ﻗﺑل ان ﺗدﻓﻊ ﺑدل اﺻدار ﺷﻬﺎدة ﻣﻳﻼد
ﻣﺎذا ﻟو ﻟم أﻛن اﺣﻣل اﻟﺟﻧﺳﻳﺔ اﻻﻣرﻳﻛﻳﺔ؟
،اذا ﻟم ﺗﻛن ﻣواطن اﻣرﻳﻛﻲ أو ﺗﺣﻣل اﻟﺟﻧﺳﻳﺔ اﻷﻣرﻳﻛﻳﺔ
ﺳﻳﻛون ﻋﻠﻳك ﻓﻘط ﺗﻘدﻳم اﻟوﺛﺎﺋق اﻟﺗﻲ ﻛﺎﻧت ﻣطﻠوﺑﺔ ﻣﻧك
.ﺳﺎﺑﻘ ﺎ ً. ﻟم ﻳﺗﻐﻳر ﺷﻲء
DHCS 0001 (01/08) – Arabic
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