How do I check my Medi-Cal benefits?
(800) 541-5555The Medi-Cal Member's beneficiary ID number. or.The last 4 digits of the Member's Social Security Number.And the Member's date of birth (2 digit month and 4-digit year) i.e. 12/1961.
What does full Medi-Cal cover?
Full scope Medi-Cal covers more than just care when you have an emergency. It provides medical, dental, mental health, and vision (eye) care. It also covers alcohol and drug use treatment, drugs your doctor orders, and more.
How do I check my Medi-Cal online?
You can access your member services online through your plan's website and the Covered California website. Each service manages different aspects of your coverage. Also, your local county office will take care of specific parts of your Medi-Cal membership.
Is everything free with Medi-Cal?
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 does Medi-Cal cover for adults?
Medi-Cal covers most medically necessary care. This includes doctor and dentist appointments, prescription drugs, vision care, family planning, mental health care, and drug or alcohol treatment. Medi-Cal also covers transportation to these services.
Can I get Kaiser through Medi-Cal?
At Kaiser Permanente, you have a wide network of doctors and specialists to choose from. All of our available doctors accept Kaiser Permanente members with Medi-Cal coverage. Get care from a doctor or specialist – including appointments, exams, and treatment.
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.
Is Medi-Cal Medicaid?
Medi-Cal is California's Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes.
What is Medi-Cal dental?
The Medi-Cal Dental Program covers a variety of dental services for Medi-Cal beneficiaries, such as: Diagnostic and preventive dental hygiene (e.g. examinations, x-rays, and teeth cleanings);
Does Medi-Cal cover blood work?
Medicaid pays for blood tests when they are ordered by a doctor as part of needed medical treatment. Laboratory tests are included as a mandatory benefit in all 51 Medicaid programs in the United States as a covered benefit.
How much does Medi-Cal cover?
Californians who qualify may be able to receive Medi-Cal by paying a small monthly premium based on their income. Premiums range from $20 to $250 per month for an individual or from $30 to $375 for a couple. To qualify, you must: Meet the medical requirements of Social Security's definition of disability.
What are the two types of Medi-Cal?
This guidebook explains the two kinds of Medi-Cal: Regular Medi-Cal and Medi-Cal Health Plans.
What is a Medi-Cal plan?
California’s Medicaid program, Medi-Cal, helps Californians in specific groups get free or low-cost health care. Medi-Cal plans offer the same benefits as private plans, but they have a much lower price. Low-income Californians who don’t qualify for Medi-Cal may have eligibility for financial assistance ...
What if I don't qualify for Medi-Cal?
Coverage Through the Affordable Care Act and Covered California. If you don’t qualify for Medi-Cal, you may still have financial assistance options. Applicants who earn between 138 and 400 percent of the federal poverty line can get a tax subsidy.
What services does Medi-Cal cover?
Children’s services, including vision and oral care. Physical and occupational therapy and related devices. People who have Medi-Cal may have full-scope or partial-scope coverage. Full-scope coverage includes all services covered under Medi-Cal, and partial-scope coverage involves some of these services.
How long does it take to choose a Medi-Cal plan?
However, they must choose a plan within 30 days, or the State of California will choose for them. Select counties have one plan available that automatically becomes the member’s plan. The price of a Medi-Cal plan depends on a variety of factors, including income. You may have no cost to pay for your Medi-Cal coverage, ...
Can low income people in California get medical assistance?
Low-income Californians who don’t qualify for Medi-Cal may have eligibility for financial assistance through Covered California. These options make it easier for people in California to afford health care.
Can I get Medi-Cal if I am in poverty?
After you apply for Medi-Cal, you will receive a letter of determination that explains your eligibility and cost share. Under federal law , you cannot get premium assistance for a Covered California plan if you qualify for Medi-Cal . However, Medi-Cal covers all or most costs for many members.
Does Medi-Cal have health insurance?
Medi-Cal members get free or low-cost coverage through a public or commercial insurance plan. Each Medi-Cal plan’s specific benefits may vary, but they must provide the Affordable Care Act’s 10 “ess ential health benefits” that include: Preventive care, chronic disease management and wellness services. Prescription drugs.
What is Medi-Cal in California?
Medi-Cal is California's Medicaid program . This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources. Visit each topic below to learn more about the Medi-Cal process:
How long does it take to get a Medi-Cal plan?
Remember, if you do not choose a plan within 30 days of receiving your health plan information mailer, Medi-Cal will choose a plan for you. If you live in San Benito County, there is only one health plan available and you may enroll in this health plan. However, you may choose to stay with Fee-for-Service Medi-Cal.
How long does it take to choose a health plan?
However, you must choose a health plan within 30 days of receiving your health plan information mailer. If you do not choose a plan within 30 days , Medi-Cal will choose a plan for you. The health plans available to you depend on what county you live in. Go to the Medi-Cal managed Care Health Plan Directory to find your county.
How to apply for a stipend in California?
Apply – complete the application, and submit either in person, by mail, by phone, or online. Receive a Notification of Likely Eligibility by mail. Your county's social services office may contact you by mail or by phone to request paper verification if income, citizenship, and other criteria cannot be verified electronically. ...
What happens when you receive your BIC?
Receive your BIC – when you receive your BIC in the mail, you are able to use the many Medi-Cal benefits available to you.
Who can take Medi-Cal?
Doctors, nurse practitioners, nurse midwives, physician assistants, and clinics in your medical plan . Any family planning practitioner or clinic outside of your medical plan that takes Medi-Cal. You do not need to ask your medical plan first.
What happens after you join a medical plan?
Medical plan benefits. Main Content. After you join a medical plan, you will get most of your Medi-Cal benefits through that medical plan. All plans offer the same basic benefits plus some extra services.
How to view the member handbook for each medical plan?
To view the member handbook for each medical plan, go to the Health plan materials page. To compare the benefits of each medical plan , go to the Compare medical plans and dental plans page. Learn.
Does Medi-Cal have co-pays?
Medi-Cal managed care medical plan: no cost to you and no co-pays. Choose a doctor or clinic. After you choose a medical plan, you choose a primary care provider (PCP) — a doctor or clinic that belongs to your medical plan. You must go to your PCP first for your health care.
Medi-Cal Learning Portal
The Medi-Cal Learning Portal (MLP) is the new, easy-to-use, one-stop learning center for Medi-Cal billers and providers.
Medi-Cal Subscription Service
The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails for urgent announcements and other updates shortly after they post to the Medi-Cal website.
How does health insurance handle premium payments?
Your health insurance company handles: Premium payments: When you need to make a premium payment, your health insurance company will accept it online or by phone. ID cards: Your insurance company will issue your membership ID card. They can also send you a replacement card if you lose it.
What is the number to call for Medi-Cal?
For general questions about Medi-Cal, members and medical providers can call the official helpline at 1-800-541-5555. Depending on the situation, you may also call Covered California at 1-800-300-1506 or your county’s Medi-Cal office.
How to switch Medi-Cal plan?
To switch your Medi-Cal plan, you can call Medi-Cal Managed Care Health Care Options at 1-800-430-4263. You may also complete a Medi-Cal Choice Form that you can find on the Health Care Options download page. Choose your county from the drop-down menu, then look for the form link under “Choice enrollment forms.”.
How to cancel Medi-Cal?
If you need to cancel your Medi-Cal coverage, call your local county office. Once you are released from Medi-Cal, call 1-877-752-4737 option 3 to be enrolled in a Covered California plan. Be aware that there are different income limits for Medicaid/Medi-Cal versus Covered California (the state exchange.)
Can Medi-Cal members access the internet?
Medi-Cal members can receive member services through the Internet or by phone. Most insurance plans have online member assistance, and many companies also allow you to call them to receive direct help. Covered California also has online member services that you can access through an account.
Does Covered California take care of medical providers?
Covered medical providers: Your plan’s company can help you find a covered medical provider or change your primary care physician. Meanwhile, Covered California takes care of: Enrollment: You can determine if you qualify for a special enrollment period, learn when you can enroll or enroll in a Medi-Cal plan through Covered California.
Can I change my Medi-Cal plan to private?
Changing to a private plan: You can enroll in a private plan through Covered California if you will los e your Medi-Cal coverage soon. When you need to renew your Medi-Cal plan, your county social services office will assist. They will get in contact with you if they need any information or send you a renewal form.
