What is the MC 382 form?
Form MC 382, Appointment of Authorized Representative, is a California Department of Health Care Services document that lets a Medi-Cal applicant or beneficiary name a trusted person to act on their behalf with the county. People use it when a family member, friend, social worker, attorney, or community organization needs to handle parts of the Medi-Cal case for them. The signed form gives the named representative the authority to apply, renew, and respond to county notices.
What is MC 382 used for?
MC 382 spells out the authority a Medi-Cal applicant or beneficiary gives to a named representative for the case. People use the form to:
- Authorize a family member, friend, or attorney to manage the case
- Allow a hospital, clinic, or community partner to file and renew applications
- Receive county notices, forms, and decisions on behalf of the applicant
- Sign documents, give information, and request a state hearing when needed
How to fill out MC 382
- 1
Enter your name, date of birth, address, phone number, and Medi-Cal case number at the top.
- 2
List the authorized representative's full name, address, phone, and relationship to you.
- 3
Mark the actions the representative can take, such as applying, renewing, or filing appeals.
- 4
Add any time limits or specific case types the authority covers.
- 5
Acknowledge the rules about ending the appointment and protecting your information.
- 6
Review every section for accuracy before sharing the completed form.
Who needs to file MC 382?
Medi-Cal applicants and beneficiaries who want someone else to act on their behalf with the county complete MC 382. Common signers include older adults working with adult children, people with disabilities working with family or social workers, parents working with hospital staff, and people supported by community-based organizations or attorneys.
After the form is signed, the county Medi-Cal office logs the authorization and sends future notices, forms, and decisions to both the applicant and the named representative. The representative can then sign documents, share information, and request a state hearing tied to the case until the authorization ends.
Who doesn't need to file MC 382?
Medi-Cal applicants who handle their own case directly with the county do not need MC 382. People with a guardianship order, conservatorship order, or durable power of attorney for health care decisions can often rely on those legal documents instead, although the county may still want a copy on file. Out-of-state Medicaid programs use their own authorized representative forms rather than this California one.
When is MC 382 due?
The deadline for MC 382 is whenever you want the authorization to start, since the county only acts on behalf of a representative once the signed form is in the case file. Many people send it with the original Medi-Cal application or at renewal time. You can also send it any time during the case to add or change a representative when your situation shifts.
How to get MC 382
The California Department of Health Care Services issues MC 382 through the Medi-Cal forms library, and county welfare offices keep current copies on hand. Need a clean copy today? Fill our blank in the editor, download the PDF, and get both signatures — the county Medi-Cal office still receives the signed original to log the authorization.
How to sign MC 382
MC 382 must be signed by hand in ink by both the Medi-Cal applicant and the named representative, since the form gives the representative authority on the case. After you fill the form on our platform, download the completed file, print it, and bring it to both signers for ink signatures and dates. Checking the latest county Medi-Cal guidance is a good idea before submitting.
Where to file MC 382
Once your MC 382 is signed, return it to the county Medi-Cal office handling your case, by mail to the address on your renewal or notice, in person at the local welfare office, by fax, or through a county online portal such as BenefitsCal where one is offered. Confirm the preferred channel with your county eligibility worker before sending.
