1. (a) An applicant or beneficiary may withdraw an application for or request discontinuance from Medi-Cal by any of the following methods:

   1. (1) Completion of a Request for Withdrawal of Application or Discontinuance of Eligibility form.

      1. (A) The original shall be placed in the case file.
      2. (B) A copy shall be given to the applicant.
   2. (2) Submission of a signed request for withdrawal or discontinuance. The request for withdrawal or discontinuance shall be placed in the case file.
   3. (3) Failing to respond to a Notice of Action which requests that the beneficiary contact the county to indicate a desire to continue eligibility.

Note: Authority cited: Sections 10725 and 14124.5, Welfare and Institutions Code. Reference: Sections 11050 and 14001, Welfare and Institutions Code.

History

1. Editorial correction filed 7-7-83 (Register 83, No. 29).