Form Dhcs 0001 - California U.s. Citizens And Nationals Applying For Medi-Cal Must Show Proof Of Citizenship And Identity (Hmong) - Health And Human Services Agency
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4State of California – Health and Human Services Agency
Department of Health Care Services
Cov Neeg Thov Medi-Cal Uas Yog Neeg Amelikas thiab Neeg Tebchaws No
Yuavtsum Tau Muaj Puavpheej Qhia Tias Nws Yog Neeg Amelikas thiab Yog Leejtwg Tiag
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
Yog kuv tsis yog ib tus li cov neeg uas hais los saumtoj
Kuv yuav mus muab cov puavpheej uas qhia tias kuv
no nev?
yog neeg Amelikas licas?
Yog koj yog ib tus neeg Amelikas lossis neeg ntawm lub
Yog koj yug rau hauv lub xeev Kalifonias, tej zaum lub
tebchaws no, koj yuavtsum tau muaj puavpheej uas qhia
county yuav mus yuav tau koj daim ntawv yug. (Daim
tias koj yog neeg Amelikas thiab yog leejtwg tiag koj thiaj
ntawv yug yog ib yam puavpheej uas qhia tias koj yog
yuav tau txais Medi-Cal. (Xyuas nplooj 3 txog cov uas luag
neeg Amelikas.)
txais los ua puavpheej qhia tias koj yog neeg Amelikas
Ua daim Ntawv Thov Ntawv Yug hauv Kalifonias rau lub
thiab yog leejtwg tiag.)
county pab mus yuav koj daim ntawv yug. Tomqab ntawd
Koj yuav tsis tau txais cov Medi-Cal uas kho tau txhua yam
muab xa mus lossis nqa mus rau lub chaw pabcuam
txog thaum koj muab cov puavpheej ntawd tuaj.
pejxeem hauv koj lub nroog. Yog tias lawv nrhiav tsis tau
koj daim ntawv yug, koj yuav tau muab lwm yam puavpheej
Cov neeg hauv tebchaws no uas suav cov neeg uas yug
uas qhia tias koj yog neeg Amelikas. Xyuas nplooj 3 txog
hauv American Samoa (suav Swains Island) thiab tuaj hauv
cov uas luag txais los ua puavpheej qhia tias koj yog
cov Koog Povtxwv Northern Mariana Islands tuaj.
neeg Amelikas.
Nug koj lub county saib yuav muab yam puavpheej uas
Yog tias kuv TSIS yog ib tus neeg Amelikas nev?
qhia tias koj yog neeg Amelikas licas yog koj tsis yog yug
rau hauv lub xeev Kalifonias. Hu mus nug lub county saib
Yog tias koj tsis yog ib tus neeg Amelikas lossis neeg
lawv puas nrhiav tau koj daim ntawv yug uantej koj yuav
tebchaws no, koj tsuas tau muab cov ntaub ntawv li qub
mus them nyiaj yuav ib daim ntawv yug.
tuaj xwb. Nws tsis tau muaj dabtsi hloov.
DHCS 0001 (01/08) – Hmong
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