Medi-Cal Application Instructions
- Apply On-Line. E-benefits California (www.benefitscal.org) is an on-line website that allows you to apply for Medi-Cal on-line.
- Apply in Person or by Mail. It is recommended that you download the application first. Applications in various languages can be found by clicking here.
- Verification process for Medi-Cal. In order to qualify for Medi-Cal, applicants will have to provide certain documents for verification.
- Other benefit programs related to Medi-Cal. Supplemental Security Income (SSI): Those qualifying for SSI will automatically qualify for receiving full Medi-Cal benefits.
Who is eligible for Medi-Cal?
The following people may qualify for Medi-Cal because they are considered medically indigent:
- Pregnant women without access to public assistance programs (such as CalWORKs)
- Individuals between the ages of 21 and 65 who reside at nursing facilities
- Individuals under 21 who receive public funds
- Several categories of children including those who qualify for various state programs
What qualifies you for Medi Cal?
You can also get Medi-Cal if you are: 65 or older. Blind. Disabled. Under 21. Pregnant. In a skilled nursing or intermediate care home. On refugee status for a limited time, depending how long you have been in the United States. A parent or caretaker relative of an age eligible child.
How to get straight Medi Cal?
- Dual Eligibles, or those with Medicare
- Foster Children
- Identified as Long Term Care (LTC)
- Those with Other Health Insurance
- Share of Cost (SOC) Medi-Cal
- California Children's Services (CCS) - Only CCS members in Alameda, Los Angeles, and San Diego counties will be voluntary; all other CCS members are mandatory for managed care
Who qualifies for Medi Cal?
The general rule of thumb is to keep your credit utilization rate below 30%, but a FICO study found that consumers with credit scores 750 and above use less than 10% of their total available credit limit. It can also be worth checking your credit report for any errors that may be dragging your credit score down.
Who qualifies for Medi-Cal Medi-Cal?
To qualify for free Medi-Cal coverage, you need to earn less than 138% of the poverty level, based on the number of people who live in your home. The income limits based on household size are: One person: $17,609. Two people: $23,792.
What documents do you need to apply for Medi-Cal?
Documents to Confirm EligibilitySocial Security Number.Identity.Citizenship.Immigration Status.Income.Not Incarcerated.Minimum Essential Coverage.American Indian or Alaskan Native.More items...
How do I apply for Medi Medi?
Apply for Medi-CalApply By Mail. Medi-Cal Single Streamlined Application. Apply for Medi-Cal with a Single Streamlined Application, provided in English and other languages. ... Apply In Person. County Social Services Office. ... Apply Online Covered California Website.
What is the income limit to qualify for Medi-Cal?
According to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income.
How long does it take to get approved by Medi-Cal?
45 daysThe process for verifying your Medi-Cal eligibility, from the time your completed application is received to when you receive your Benefits Identification Card (BIC), normally takes 45 days.
Does Medi-Cal check your bank account?
Because of this look back period, the agency that governs the state's Medicaid program will ask for financial statements (checking, savings, IRA, etc.) for 60-months immediately preceeding to one's application date. (Again, 30-months in California).
What is the difference between Medi-Cal and Medicare?
Medicare provides health coverage to individuals 65 and older or those with a severe disability regardless of income, whereas Medi-Cal (California's state-run and funded Medicaid program) provides health coverage to those families with very low income, as well as pregnant women and the blind, among others.
What is the income limit for Medi-Cal 2021?
A single adult can earn up to $17,775 in 2021 and still qualify for Medi-Cal. A single adult with one dependent can earn up to $46,338 annually and the child will still be eligible for Medi-Cal.
How much does Medi-Cal cost?
For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. Some households will see affordable costs, such as a low monthly premium. For some Medi-Cal children, the monthly premiums are $13 per child up to a family maximum of $39 per month.
What income is not counted for Medi-Cal?
Income-based Medi-Cal counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts.
Is Covered California the same as Medi-Cal?
Medi-Cal offers low-cost or free health coverage to eligible Californian residents with limited income. Covered California is the state's health insurance marketplace where Californians can shop for health plans and access financial assistance if they qualify for it.
Do I qualify for CalOptima?
It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. CalOptima provides health care coverage for Orange County residents who are eligible for full Medi-Cal.
Does Medi Medi cover dental?
Medi-Cal offers comprehensive preventative and restorative dental benefits to both children and adults. You can find a Medi-Cal dentist on the Medi-Cal Dental Provider Referral List, or by calling 1-800-322-6384.
Can I apply for Medi-Cal over the phone?
During the Medi-Cal application process, you can apply online, by phone or in person. The application requires information about you and your family members that helps your local agency determine your eligibility.
How do I contact Medi-Cal?
(800) 541-5555 Medi-Cal Members and Providers: If you have a question, need help, or need to report a problem, please call (800) 541-5555 (outside of California, please call (916) 636-1980) for our Telephone Service Center. DHCS' hours are Monday through Friday from 8 a.m. to 5 p.m., except holidays.
Where can I apply for health insurance?
for Health Insurance. You can apply in person at your local county office, on the phone, or download, fill out, and. submit your application to your local county social services office. Locate your local county office.
How many people have Medi-Cal?
As a result of the Affordable Care Act (ACA) that began in 2014, Medi-Cal has provided health coverage to approximately 2.7 million new people.
What is covered California?
Covered California is a “one-stop shop” for your health insurance needs. Through Covered California, you are able to apply for Medi-Cal benefits electronically and receive real-time eligibility results. You can also report changes online and receive real-time customer support 24 hours a day.
Can I qualify for Medi-Cal?
Yes. Qualifying for Medi-Cal is now simpler than ever. For most individuals, Medi- Cal eligi bility is based on your household size and your income. Medi-Cal also attempts to verify your information electronically so you may be found eligible for benefits without ever having to provide paper verifications.
How do I apply for Medi-Cal?
During the Medi-Cal application process, you can apply online, by phone or in person. The application requires information about you and your family members that helps your local agency determine your eligibility. You will need to provide these details about each person your household: Age. Employment.
What happens after you apply for Medi-Cal?
After you apply, you will receive a letter of determination letting you know if anyone in your family qualifies for Medi-Cal. Covered California will keep all of your information secure according to federal and state law.
Does Medi-Cal cover physical therapy?
Physical and occupational therapy and related devices. Under Medi-Cal, a member may have full-scope or partial-scope coverage. Full-scope coverage involves all Medi-Cal coverage, while partial-scope coverage includes some services.
Can I still get Medi-Cal if I have private insurance?
If you have private health insurance, you can still qualify for Medi-Cal. Members who already have insurance can add Medi-Cal coverage to their existing plan. Your provider will first bill your private insurance, and then Medi-Cal will pay for any additional services it covers.
Who may qualify for Medi-Cal?
Who May Qualify for the Medi-Cal Program. You and/or your family may qualify for participation in the Medi-Cal program. Even if you are working, own a house, own a car, are married, or are not a U.S. Citizen, you may be eligible for Medi-Cal health care benefits.
How to contact HCO about Medi-Cal?
Medi-Cal participants and applicants may be referred by County Eligibility workers, by the HCO Call Center (1-800-430-4263) , by the informing packet materials they receive in the mail, or you can just walk-in and ask for the Health Care Option representative.
How to contact Human Services Technician?
Or by calling IVR at 1 (877) 410-8812.
What is the difference between Medicare and Medi-Cal?
When you have Medicare Parts A and B, Medicare is your primary insurance and pays for most of your medical care. Medi-Cal is your secondary insurance. It pays for costs not covered by Medicare and provides additional benefits not covered by Medicare.
What is Cal MediConnect?
Cal MediConnect is a type of health care plan that promotes coordinated healthcare and long-term services and supports (LTSS) for seniors and people with disabilities who are eligible for both Medicare and Medi-Cal, sometimes referred to as “dual eligible beneficiaries” or “Medi-Medis”.
What is a medicaid program?
What is Medi-Cal? Medicaid, called Medi-Cal in California, is a joint federal and state program that helps pay medical costs for people with limited income and/or resources (assets). Some people qualify for both Medicare and Medi-Cal.
Does California have Medicare and Medi-Cal?
Medicare is working with some states and health plans to offer demonstration plans for certain people who have both Medicare and Medi-Cal. California is one of these states.
Does Medicare cover medical expenses?
If you have Medicare and full Medi-Cal coverage, most of your health care costs are covered. People with Medi-Cal may get coverage for services that Medicare may not or may partially cover, like basic vision and hearing, dental, non-emergency transportation, incontinence supplies, personal care, and home-and community-based services.
Do you need a referral for a MA plan?
Plan members are assigned a medical group (network of providers) and referrals are required prior to seeing a specialist. MA plans pay first, and Medi-Cal pays any remaining cost sharing amounts. Beneficiaries need only present their MA Plan card when obtaining medical services.
Does Medi-Medi qualify for extra help?
Medi-Medi beneficiaries that do not enroll in a Part D Plan or a Medicare Advantage Plan will automatically be enrolled in a Part D benchmark plan. Medi-Medi beneficiaries are automatically eligible for Extra Help, the program that helps pay for prescription drug plan co-payments.
