If you need help filling out the form, call 1-80 (TTY 1-80). It will help you ask for an exemption (release) from having to join a plan. Use this form if you do not want to join a medical plan for medical reasons. Request for medical exemption from plan enrollment.Or call 1-80 (TTY 1-80).Įxception and exemption to plan enrollment forms If you need help filling out the form, read How to fill out a dental form. Use this form to join or change your dental plan, or to return to Regular Medi-Cal. Medi-Cal Managed Care Choice Enrollment Form – Dental.If you need help filling out the form, read How to fill out a medical form. Use this form to join or change your medical plan. Medi-Cal Managed Care Choice Enrollment Form – Medical.Use this form to find meeting places and times for Los Angeles. You can go to any session to hear about your choices and ask questions in person. The sessions are about choosing Medi-Cal managed care plans. You can download Adobe Reader for free here. You must have the newest version of Adobe Reader to use these forms.
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