Medi-Cal – Proofs

  • Income
    • If employed: A copy of most recent pay stub with name of employer and name of the employee or Federal Income Tax Return
      or a Signed statement from employer including gross monthly income and dates received
    • If employed: A copy of most recent pay stub with name of employer and name of the employee;
    • or a Signed statement from employer including gross monthly income and dates received
    • If self-employed: A copy of last year’s Federal tax return (with Schedule C) or last 3 months’ profit and loss statements
    • If disabled, unemployed, or retired: Copies of award letters or bank statements showing direct deposits
    • If disabled or retired: Copies of award letters or bank statements showing direct deposits
    • If currently receiving benefits: Proof of amount (i.e., unemployment insurance, Social Security, Workers’ Compensation, veteran income checks or disability insurance)
    • In-kind letter – Contribution letter from provider
    • If income from a loan: A copy of loan papers with the name of person who is receiving the loan, the loan amount and current balance
    • If unearned income: Child support and/or spousal support award letter, copies of check received, and statement from Child Support Services Department for last month
  • Resources
    • Proof of Resources: All current bank statements, property statements, auto registrations, life and/or burial insurance policies, life estate agreement
  • Identity
    • Resident Alien Card (if not a US Citizen) or other residency documents
    • School Identification with photo
    • Original or certified copy of US Citizenship (if US Citizen). Please note that photocopies of identifying documents will not be accepted
    • Proof of California Residency: Driver’s License, State ID Card, or current letter mailed to you at your address
    • US Military ID Card
    • Social Security Card
    • Medicare Card or other health insurance card
    • If pregnant or applying for unborn child, Proof of Pregnancy
    • How can I prove my identity to sign up for Medi-Cal and/or Covered CA?
  • Expenses/Deductions
    • Proof of Expenses/Proof of Deductions: Work clothing and transportation costs, current taxes, medical insurance, etc.
    • For care of a child or disabled adult: Receipts, bill or cancelled checks that show name of the person cared for, cost of care, and the name of the person who paid for the care
    • For housing and utility costs: Receipts or bills that show user’s name and amount due
    • For medical costs for the disabled or persons age 60 or older: Bills, receipts, or cancelled checks that show the name of the person who incurred the expense, cost, and name of person who paid for the care
    • For court ordered support payments: Receipts, cancelled checks or money orders that show who the payment was for, and the amount paid
    • For self-employed: Signed receipts, cancelled checks or statements from your suppliers
  • Verification of citizenship/national status/legal permanent resident for 5+ years
    • U.S. birth certificate
    • U.S. passport
    • Certificate of Naturalization or Certificate of U.S. Citizenship
    • Legal Permanent Resident Alien Card effective for 5+ years

Click Here For the Most Commonly Requested Documents for most of the health and human services programs and where they may be obtained LA County Helps.org

Covered CA Listing  *   Medi-Cal Proofs – Page 8   

 

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