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Medi-Cal Eligibility Confirmation

You can start using Medi-Cal for health care services today. Bring a printout of this Eligibility
Confirmation to your doctor or health care provider. They will be able to use the information
below to verify your eligibility for medical and dental expenses.

Jason Schmit

91404234E 12/06/2019
CIN Effective Date

10/27/1970 Male
Birth date Gender

If a BIC card has not previously been issued to you, you will receive one in the mail in
approximately 10 days. If you no longer have a BIC card that was issued to you, contact your
local country office to request a new one. Once received, you should show your BIC to your
doctor instead of this printout.

CoveredCA.com

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