CalFresh + Medi-Cal + CalWORKs — SAWS 2 PLUS packet
Combined CalFresh + Medi-Cal + CalWORKs single application (SAWS 2 PLUS / BenefitsCal)
- 1Fill it out
- 2Review
- 3Sign
- 4Download
About you
CalFresh + CalWORKs require an SSN (Medi-Cal does not). Default: leave blank here and write it on the printed packet at your county appointment — your eligibility worker asks for it in person. Tap 'Enter digitally' below only if you want a fully-completed PDF; values are encrypted on our servers and auto-deleted after 30 days.
If you're escaping abuse or unsafe at your current address, ask the partner where you'll submit this form whether you can use a safe-address (FJC, library, or partner agency). We won't track which address you used.
How we handle addresses →Full-scope Medi-Cal covers all income-eligible residents regardless of status. CalFresh + CalWORKs have stricter federal rules — your worker will confirm which programs apply.
Household + income
Wages, SSI, SSDI, VA, UI, child support, gig work — list each source.
Expenses (for net-income calculation)
Deductible expenses lower your net income and may qualify you for more aid.
Anything the worker needs to know
Your answers save automatically as you type.