HomeMy WebLinkAboutenrollment-documents-list NEW ENROLLMENT DOCUMENTS LIST
To enroll, you will need to bring the following information to your appointment:
Medi-Cal
Photo ID for adults
Proof of citizenship/lawful presence for each family member applying (U.S. passport; birth
certificate; certificate of citizenship/naturalization; legal permanent resident card;
employment authorization card; Notice of action from USCIS; etc.)
Social security cards/numbers for each family member applying or receipt that has applied
Proof of income for all members in the immediate household (1 month of most recent check
stubs, letter from employer, or taxes if self-employed. If paid monthly=1 stub; paid biweekly
or semi-monthly=2 stubs; paid weekly=4 stubs)
Most recent tax return
Proof of address (current utility bill with name and address or copy of school registration)
Proof of pregnancy (if applicable)
Covered CA
Photo ID for adults
Proof of citizenship/lawful presence for each family member applying
Social security cards/numbers for each family member applying
Proof of income for all members in the tax household.
Most recent tax return
CalFresh (foodstamps)
Photo ID for adults
Proof of citizenship/lawful presence for each family member applying
Social security cards/numbers for each family member applying or receipt that has applied
Proof of income for all members in the household that purchase and prepare meals
together.
Proof of expenses (rent or mortgage receipt; all utility bills such as water, PG&E, garbage;
phone bill; receipt of daycare expenses)
Recent bank statements
HealthPAC
Picture ID for each family member applying
Proof of income for all members in the immediate household.
Proof of address (current utility bill, bank statement, car registration or letter of support from
host family with a utility bill in their name)
Kaiser Child Health Program
Proof of income for all members in the immediate household (1 full month of check stubs for
the previous month or taxes if self-employed)
Foreign birth certificate for each child applying
Proof of adult’s guardianship (if applicable)