Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with San Joaquin County Human Services Agency before sending sensitive documents. FaxFlow is not affiliated with this organization.
San Joaquin County Human Services Agency fax number
(209) 932-2691
QMB/SLMB/QI Program (Medicare Savings Program)
Used for: Submitting Medicare Savings Program applications and related documents
Fax destination details
- Department
- QMB/SLMB/QI Program (Medicare Savings Program)
- Purpose
- Submitting Medicare Savings Program applications and related documents
- Form
- QMB/SLMB/QI Application Form (C01-48) — Qualified Medicare Beneficiary (QMB)/Specified Low-Income Medicare Beneficiary (SLMB)/Qualifying Individual (QI) Application Form
- Address
- 333 East Washington Street, Stockton, CA 95201-3006
- Voice phone
- 209-468-1357
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Instructions for completing the QMB/SLMB/QI application are provided in the C01-48 form PDF; county coordinators’ list MC14a-CntyList references the program.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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