Difference between revisions of "California - CA"

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'''Food Stamps/CalFresh Action Letters'''
 
'''Food Stamps/CalFresh Action Letters'''
[[File:Ca-cal-fresh_approval_letter.png]][[File:Ca-cal-fresh_action_letter.png]][[File:Ca-cal-fresh_expiration_letter.png]][[File:Ca-fs_letter2.gif]][[File:Ca-snap_letter.gif]][[File:Ca-snap_cf_letter.gif]][[File:Ca-calfresh verification letter.gif]][[File:Ca-fs agency printout.gif]][[File:Ca-snap printout.png]][[File:Ca-sc benefits verification letter.gif]][[File:Ca- sm fs approval letter.gif]]
+
[[File:Ca-cal-fresh_approval_letter.png]][[File:Ca-cal-fresh_action_letter.png]][[File:Ca-cal-fresh_expiration_letter.png]][[File:Ca-fs_letter2.gif]][[File:Ca-snap_letter.gif]][[File:Ca-snap_cf_letter.gif]][[File:Ca-calfresh verification letter.gif]][[File:Ca-fs agency printout.gif]][[File:Ca-snap printout.png]][[File:Ca-sc benefits verification letter.gif]]
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 +
 
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[[File:Ca- sm fs approval letter.gif]]
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*Must be dated no more than one month prior to enrollment date.
  
  
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'''Medicaid/Medi-Cal Cards'''
 
'''Medicaid/Medi-Cal Cards'''
[[File:Ca-medi_cal.png]][[File:Ca=la care medX2.gif]][[File:Ca-another medi-cal card.png]][[File:Ca-anthem medi-calX.gif]][[File:Ca-caloptima medX.gif]][[File:Ca-calviva medi-calX.gif]][[File:Ca-chw medi-cal.gif]][[File:Ca-community medX.gif]][[File:Ca-hp sj medX.gif]][[File:Ca-hpsm medX2.gif]][[File:Ca-mediconnedct la careX.gif]][[File:Ca-sc medX.gif]][[File:Ca-sf medX.gif]][[File:Ca-sfhp medX.gif]][[File:Ca-anthem oakland medi-calX.gif]][[File:Ca-different la care medi-calX.gif]][[File:Ca-alliance mcalX.gif]][[File:Ca-sfhp mediX.gif]][[File:Ca-iehp_dualX.gif]][[File:Ca-sc med connectX.gif]][[File:Ca-anthem mediconnectX.gif]][[File:Ca-old bcbs medi-calX.gif]][[File:Ca-caloptima med-icalX.gif]][[File:Ca-hpsj medi-caX.gif]][[File:Community health medi-calX.gif]][[File:Ca-health net medi-calX.gif]][[File:Ca-access med-calX.gif]][[File:Ca-hpsj medi-cal4X.gif]][[File:Ca-liberty medi-calX.gif]][[File:Ca-another benefits ID card-medi-calX.gif]][[File:Ca-community medi-connectX.gif]][[File:Ca-cchp medi-calX2.gif]][[File:Ca-another chw medX.gif]][[File:CA-optima mediconnectX.gif]][[File:Ca-spanish mcX.gif]][[File:Ca-mcal proofX.png]][[File:Ca-molina mediconnectX.gif]][[File:Ca-health net medi-calX.gif]][[File:Ca-hpsm cal mediconnectX.gif]][[File:Ca-hpsm medi-calX.gif]][[File:Phpc.gif]][[File:Ca-new la care hp.gif]][[File:Ca-sc fammedi-cal.gif]]
+
[[File:Ca-medi_cal.png]][[File:Ca=la care medX2.gif]][[File:Ca-another medi-cal card.png]][[File:Ca-anthem medi-calX.gif]][[File:Ca-caloptima medX.gif]][[File:Ca-calviva medi-calX.gif]][[File:Ca-chw medi-cal.gif]][[File:Ca-community medX.gif]][[File:Ca-hp sj medX.gif]][[File:Ca-hpsm medX2.gif]][[File:Ca-mediconnedct la careX.gif]][[File:Ca-sc medX.gif]][[File:Ca-sf medX.gif]][[File:Ca-sfhp medX.gif]][[File:Ca-anthem oakland medi-calX.gif]][[File:Ca-different la care medi-calX.gif]][[File:Ca-alliance mcalX.gif]][[File:Ca-sfhp mediX.gif]][[File:Ca-iehp_dualX.gif]][[File:Ca-sc med connectX.gif]][[File:Ca-anthem mediconnectX.gif]][[File:Ca-old bcbs medi-calX.gif]][[File:Ca-caloptima med-icalX.gif]][[File:Ca-hpsj medi-caX.gif]][[File:Community health medi-calX.gif]][[File:Ca-health net medi-calX.gif]][[File:Ca-access med-calX.gif]][[File:Ca-hpsj medi-cal4X.gif]][[File:Ca-liberty medi-calX.gif]][[File:Ca-another benefits ID card-medi-calX.gif]][[File:Ca-community medi-connectX.gif]][[File:Ca-cchp medi-calX2.gif]][[File:Ca-another chw medX.gif]][[File:CA-optima mediconnectX.gif]][[File:Ca-spanish mcX.gif]][[File:Ca-mcal proofX.png]][[File:Ca-molina mediconnectX.gif]][[File:Ca-health net medi-calX.gif]][[File:Ca-hpsm cal mediconnectX.gif]][[File:Ca-hpsm medi-calX.gif]][[File:Phpc.gif]][[File:Ca-phcp 2.1.gif]][[File:Ca-new la care hp.gif]][[File:Ca-sc fammedi-cal.gif]]
  
  
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*BOTH sides must be uploaded.
 
*BOTH sides must be uploaded.
  
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 +
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[[File:Ca-la care chp med2.gif]]
 +
*BOTH sides must be uploaded.
  
  
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[[File:Ca-med-cal print.gif]]
 
[[File:Ca-med-cal print.gif]]
 
[[File:Ca-med-cal print2.gif]]
 
[[File:Ca-med-cal print2.gif]]
 +
[[File:Ca-kern co med letter.png]]
 
[[File:Ca-covered ca medi-cal printoutX.gif]]
 
[[File:Ca-covered ca medi-cal printoutX.gif]]
 +
[[File:Ca-cover cal med letter.gif]]
 +
[[File:Ca-prison release medi-cal.png]]
 +
[[File:Ca-medi-cal-verif-letter.gif]]
 
*Must show valid eligibility dates.
 
*Must show valid eligibility dates.
  
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'''FPHA/Section 8'''[[File:Ca-section_8.gif]][[File:Ca-sc sec 8.gif]]
+
'''FPHA/Section 8'''[[File:Ca-section_8.gif]][[File:Ca-sc sec 8.gif]][[File:Ca-sec 8 confirm letter2.jpg]]
 
 
  
  
  
'''WIC'''[[File:Ca-wic_voucher.png]][[File:Ca-wic_id.gif]]
 
  
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'''WIC'''
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[[File:Ca-new wic card.gif]]
 +
*cards that do not display a name must be accompanied by a grocery receipt that shows an active balance, be dated within 3 months of the LifeLine application, and the last 4 digits of the WIC card number shown on the receipt must match the WIC card number.
 +
[[File:Ca-wic receipt 2.gif]]
  
  
 
+
Acceptable WIC App screen shots
'''LIHEAP'''[[File:Ca-cares liheap.gif]]
+
[[File:Ca-wic screenshot.jpg]][[File:Ca-wic screenshot2.jpg]]
*CARE = California LIHEAP Program
 
*Statement date must be from past month
 
 
 
 
 
  
  
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'''Tribal TANF'''
 
'''Tribal TANF'''
 
[[File:Tribal tanf.gif]]
 
[[File:Tribal tanf.gif]]
 
+
[[File:Ca-tribal tanf letter.gif]]
  
  

Latest revision as of 11:36, 17 July 2020

Acceptable Subsidies

The standard eligibility programs that may be used as proof of subsidy include Temporary Assistance to Needy Families (TANF), Supplemental Security Income (SSI), Food Stamps (CalFresh), Medicaid - Medi-Cal, National Free School Lunch Program, Federal Public Housing Assistance (FPHA), and Low-Income Home Energy Assistance Program (LIHEAP), Veterans and Survivors Pension benefit.


State-Specific Eligibility Programs

  • Women, Infants, and Children Program (WIC)
  • TANF Programs:

California Work Opportunity and Responsibility to Kids (CalWORKs), Stanislaus County Work Opportunity and Responsibility to Kids (StanWORKs), Welfare-to-Work (WTW), Greater Avenues for Independence (GAIN)


State-Specific Tribal Eligibility Programs

  • Tribal TANF
  • Bureau of Indian Affairs General Assistance
  • Head Start Income Eligible (Tribal Only)
  • Food Distribution Program on Indian Reservations


See General Rules for more information.

UNACCEPTABLE Subsidy Proof Examples

Ca-unacceptable ssa form.gif


Acceptable Subsidy Proof Examples

Food Stamps/CalFresh Card Ca-fs.jpgCa - new snap.gif


Food Stamps/CalFresh Action Letters Ca-cal-fresh approval letter.pngCa-cal-fresh action letter.pngCa-cal-fresh expiration letter.pngCa-fs letter2.gifCa-snap letter.gifCa-snap cf letter.gifCa-calfresh verification letter.gifCa-fs agency printout.gifCa-snap printout.pngCa-sc benefits verification letter.gif



Ca- sm fs approval letter.gif

  • Must be dated no more than one month prior to enrollment date.



Medicaid/Medi-Cal Cards Ca-medi cal.pngCa=la care medX2.gifCa-another medi-cal card.pngCa-anthem medi-calX.gifCa-caloptima medX.gifCa-calviva medi-calX.gifCa-chw medi-cal.gifCa-community medX.gifCa-hp sj medX.gifCa-hpsm medX2.gifCa-mediconnedct la careX.gifCa-sc medX.gifCa-sf medX.gifCa-sfhp medX.gifCa-anthem oakland medi-calX.gifCa-different la care medi-calX.gifCa-alliance mcalX.gifCa-sfhp mediX.gifCa-iehp dualX.gifCa-sc med connectX.gifCa-anthem mediconnectX.gifCa-old bcbs medi-calX.gifCa-caloptima med-icalX.gifCa-hpsj medi-caX.gifCommunity health medi-calX.gifCa-health net medi-calX.gifCa-access med-calX.gifCa-hpsj medi-cal4X.gifCa-liberty medi-calX.gifCa-another benefits ID card-medi-calX.gifCa-community medi-connectX.gifCa-cchp medi-calX2.gifCa-another chw medX.gifCA-optima mediconnectX.gifCa-spanish mcX.gifCa-mcal proofX.pngCa-molina mediconnectX.gifCa-health net medi-calX.gifCa-hpsm cal mediconnectX.gifCa-hpsm medi-calX.gifPhpc.gifCa-phcp 2.1.gifCa-new la care hp.gifCa-sc fammedi-cal.gif



Ca-anthem la care side 1.gifCa-anthem la care side 2.gif

  • BOTH sides must be uploaded.



Ca-new anthem la care 1.gifCa-new anthem la care 2.gif

  • BOTH sides must be uploaded.



Ca-healthnet med-cal1.gifCa-healthnet med-cal2.gif

  • BOTH sides must be uploaded.



Ca-la care chp med2.gif

  • BOTH sides must be uploaded.



Ca-kern medi-cal onlyX.gifCa-gold coast medi-calX.gifCa-calviva med2X.gif

  • Kern Family Health Care, Gold Coast Health Plan, and CalViva offer only Medi-Cal.




Medicaid/Medi-Cal Approval Letters Ca-med approval letter.png Ca-medi cal approval.png Ca-medi-cal id letterX.png Ca-cc medii-cal letterX.gif Ca-med-cal printout2X.gif Ca-med-cal letterX2.gif Ca-gchp medi-calX2.gif Ca-cover medi-cal letterX.gif Ca-sc benefits verification letterX.gif Ca-med-cal print.gif Ca-med-cal print2.gif Ca-kern co med letter.png Ca-covered ca medi-cal printoutX.gif Ca-cover cal med letter.gif Ca-prison release medi-cal.png Ca-medi-cal-verif-letter.gif

  • Must show valid eligibility dates.


San joaquin letterX.gif

  • Must show valid eligibility dates.


TANF

Ca-cal-works benefits summary.png Ca-calworks form.png Ca-welfare to work.png Ca-wtw tanf.png Ca-wtw tanf (2).png Ca-calworks 2.gif

  • No amount need be given; just participating in the program qualifies them



Supplemental Security Income (SSI)

  • Must be dated within the past year.

SSI2b.gif



FPHA/Section 8Ca-section 8.gifCa-sc sec 8.gifCa-sec 8 confirm letter2.jpg



WIC Ca-new wic card.gif

  • cards that do not display a name must be accompanied by a grocery receipt that shows an active balance, be dated within 3 months of the LifeLine application, and the last 4 digits of the WIC card number shown on the receipt must match the WIC card number.

Ca-wic receipt 2.gif


Acceptable WIC App screen shots Ca-wic screenshot.jpgCa-wic screenshot2.jpg


National Free School Lunch Program Ca-free lunch.gif Ca-free school lunch3.gif Ca-free school lunch2.gif Ca-nfslp.gif


Food Distribution Program on Indian ReservationsCa-fdpir.gifCa-fdpir letter.gifCa-fdpir letter2.gifFdpir letter 2.jpg



Tribal TANF Tribal tanf.gif Ca-tribal tanf letter.gif


Acceptable Income Proof Examples

SSDI (must be dated within the past year) SSIb.gif

  • NOT PROOF OF SSI
  • Can be used to demonstrate low income eligibility.



Unemployment Benefits Printout Ca-unemployment.png

  • Can be used to demonstrate low income eligibility.



Disability Insurance Claim Letter Ca-disability income.gif

  • Can be used to demonstrate low income eligibility.


Acceptable ID Examples

Ca-dl.jpgCa-dl2.jpgCa-dl3.jpgCa-dl4.jpgCa-dl5.jpgCa-dl7.jpgCa-indian id.gifCa-sf id.gifDischarge ID.gifCa-richomnd id.gifCa-older DL.gifCa-senior id.gif




Mexican id.gifId-new mex id.gif

  • Acceptable in California ONLY



Ca-mexican passport.gifCa-iran passport.gif

  • FOREIGN passports acceptable in California ONLY

Important Links