Notification of Deceased Status
Please notify us if someone with a health plan through Covered California has died.
The following documents are accepted as proof of death:
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Copy of Death Certificate.
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Bureau of Vital Statistics records.
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Widow or survivor’s benefits on the deceased individual’s Social Security number (SSN).
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Veterans Administration or military service records.
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Hospital or medical records.
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Signed funeral director’s statement.
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Indian census records.
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Newspaper death notice (obituary).
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Insurance company records.
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Social Security records.
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Institutional records.
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Veterans Administration death payment correspondence.
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Insurance company death settlement correspondence.
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Minister or clergy statement.
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Proof of executor.
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Proof of estate.
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Probate court order (or Letter of Testamentary).
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Copy of a recorded Affidavit of Death of a Joint Tenant.
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Copy of a notarized Affidavit for Collection of Personal Property.
To confirm that someone with coverage through Covered California is not deceased, please submit a signed declaration or affidavit from the affected individual or an authorized representative that the individual is not deceased. The declaration or affidavit must include:
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Statement that the affected individual is not deceased.
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Statement that the information provided is true and correct to the best of the affected individual's knowledge.
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The date and the signature of the affected individual or their authorized representative.
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