California Medicaid (Medi-Cal) Information

California Medicaid is known as Medi-Cal and there are more than 10 million people enrolled in the California Medicaid program. The California Department of Health Care Services (DHCS) administers the Medi-Cal program.

Similar to other Medicaid programs in the United States, Medi-Cal is a public health insurance program that helps provide health care for people with low income.  

Medi-Cal also provides coverage for eligible enrollees including people with certain disabilities, foster care, pregnant women, and low-income individuals with diseases such as breast cancer, tuberculosis, or HIV/Aids.

In California, you do not have to be a U.S. Citizen to qualify for Medi-Cal. Depending on your alien status; you might be eligible for partial services or full Medi-Cal benefits.

Qualifying for Medi-Cal

You may be eligible for Medi-Cal coverage if you are currently enrolled in Supplemental Security Income (SSI), Refugee Assistance, Foster Care, In-Home Support Services (IHSS), or CalWorks (AFDC) programs. You may also qualify for Medi-Cal if you meet any of the following criteria:

65 years of age or older

You are blind

You are disabled

You are under the age of 21

You are pregnant

You are in a skilled nursing home or intermediate care home

On refugee status, for a limited time

Have been screened for cervical or breast cancer

A parent or caretaker relative of a child under 21 if:

* The parent of the child is deceased or doesn’t live with the child, or

* The parent of the child is disabled, or

* The parent of the child is unemployed or has a low income

Applying for Medi-Cal

You can apply for Medi-Cal by accessing the Medi-Cal Application Enrollment Form online or pick one up at your local Department of Social Services or County Welfare Office.

The Medicaid application forms and instructions are provided in 11 different languages. Once you have completed the application, you need to mail it to your local social services office.

If you need immediate health care services or do not have a mailing address, then take the Medi-Cal application to your nearest social services office for assistance.

Once the local social services office receives your application, you will be notified within 10 days. You will be given the name of a person that you should contact for more information about your application.

You might get a request for additional information needed to determine your Medi-Cal eligibility. In most cases, you will be notified within 45 days of your eligibility. If you are disabled, it may take up to 90 days to determine your eligibility.

If you qualify for Medi-Cal, you will be able to select a health plan that is available in your area. If you do not qualify for Medi-Cal, you can apply for the Healthy Families program at the social services office.

To apply for California Medicaid, you can download and print this pdf file and submit it to your local Medicaid office http://www.dhcs.ca.gov/services/medi-cal/Documents/PDF_Medi-Cal%20Applications/English/English%20Application.pdf.

New California Medi-Cal Law Changes

California recently change laws pertaining to Medi-Cal.  The Department of Health Care Services will no longer pay for select benefits for recipients 21 and older.  These laws went into effect on July 1, 2009. 

Changes were made which impact adult dental services, audiology or hearing services, acupuncture podiatry, optometry, incontinence treatment and psychology services.  Most other California Medi-Cal services ill remain the same.  The benefits listed below will continue to be covered:

1) You are under age 21 and you reside in a nursing facility.

2) You are pregnant and can continue to receive state sponsored pregnancy related assistance.

Medi-Cal Fair Hearings and You

If your California Medi-Cal application has been denied or you have a complaint on how the request /service was handled you can contact a representative of the welfare department in the county and file a formal complaint. 

You can also request a Medi-Cal hearing.  You can apply for a hearing in one of two ways.  First, you may complete a “Request fro State Hearing” on the back of the notice of Action form.  You will need to provide your full name, phone number, and the county that has rejected your services.  Second, you can attach a letter and explain why you believe that you should receive Medi-Cal benefits.  Mail your letter to:

California Department of Social Services, State hearings Division, P.O. Box 944243, Mail Station 19-37, Sacramento, California 94244-2430.

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The official U.S. Government Medicare Web site is cms.gov.