California - CA

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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


  • Verification of Benefit forms
  • Issuance Summary forms
  • Human Services Agency Passport to Services forms


Acceptable Subsidy Proof Examples

EBT front.png

Acceptable document:

  • Golden State Advantage (EBT) card and a successful purchase receipt

Card must display:

  • The applicant’s name, or the name of applicant’s benefit qualifying person (BQP)


Receipt.png

Receipt must display:

  • A date not more than seven (7) calendar days prior to the date the TPA receives the application and supporting documents
  • The last four (4) digits of the EBT card displayed by the receipt must match the last four (4) digits of the EBT card
  • A CalFresh account balance greater than $0.00


Notice of Approval for CalFresh Benefits SNAP-Calfresh Notice Letter of Approval.png

  • Notice of Approval For CalFresh Benefits must appear on the document
  • The applicant’s name, or the name of the applicant’s benefit qualifying person (BQP) must appear on the document
  • A certification period “from” date that is not more than 7 calendar days prior to the date of the application must appear on the document
  • A Total Amount of Benefits greater than $0.00



CalFresh Notice of Action SNAP-Calfresh Notice of Action.png

  • The NOTICE OF ACTION form identifier must appear on the document
  • The applicant’s name, or the name of applicant’s benefit qualifying person (BQP) must appear on the document
  • Must specifically mention CalFresh on the document
  • The Notice Date must be no more than 7 calendar days before the date of the application



Medi-Cal Ca med BIC ID no.png

Acceptable document:

  • State of California Benefits Identification Card (BIC)

Acceptable BIC variations:

  • Blue and White - issued prior to 09/12/2016
  • California Poppies - issued after 09/12/2016

Must display:

  • The applicant's name, or the name of applicant's benefit qualifying person (BQP)
  • An issuance date outside the most recent calendar year is acceptable

Important considerations:

  • Cards issued prior to 3/36/3003 can display the cardholder’s Social Security Number as the ID No.
  • Cards issued after 3/26/2003, must display ID Nos which begin with “9”s, characters 2 through 8 must be numeric, and the 9th character must be alphabetic
  • Cards issued after 8/31/2021, do not display a gender indicator (M/F) prior to the cardholder’s date of birth




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-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 Ca verifcation receipt.gif Ca-caloptimahealthmedi-cal.png Ca-caloptimamedi-calauthsum.png


Magejpeg 0.jpg

  • Must show valid eligibility dates.


Ca-medi-cal notice of action approval letter.png

  • Must be dated within the past year.



CA - LA County Medi-Cal AVES Cert.png


CA - LA County Medi-Cal Check.png




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

Must display:

  • The applicant's name, or the name of applicant’s benefit qualifying person (BQP)
  • A Notice Date not more than three hundred sixty-five (365) calendar days prior to the date the TPA receives the application and supporting documents
  • The name of the qualifying program
  • The name of the entity or agency which issued the document




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

Must display:

  • The applicant's name, or the name of applicant's benefit qualifying person (BQP)
  • The phrase “TANF”
  • A notice date not more than three hundred sixty-five (365) calendar days prior to the date the TPA receives the application and

supporting documents

  • A monthly Tribal TANF monetary benefit greater than $0.00
  • The name of the federally recognized Tribe or Tribal agency which issued the document



Low Income Energy Assistance Program (LIHEAP) Ca-heap.png



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.


Emergency Unemployment Benefits Extension Award Letter (Spanish) Ca-ui spanish.gif

  • 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



Parolee ID CA Parole ID.jpg

  • Acceptable in California ONLY



Parolee ID CDCR ID.gif

  • Acceptable in California ONLY


CA - LA County Sheriff’s Department, Community Transition Unit’s Post Release Services.png

  • Acceptable in California ONLY


Ca-mexican passport.gifCa-iran passport.gif

  • FOREIGN passports acceptable in California ONLY

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