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Medi-Cal FAQs

  • 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. In general, individuals in Medi-Cal will get the same health benefits available through Covered California at a lower cost.
  • What is the difference in coverage between Medi-Cal and Covered California?
    Medi-Cal is health coverage, just like the coverage offered through Covered California. Medi-Cal provides benefits similar to the coverage options available through Covered California, but often at lower or no cost to you or your family. All of the health plans offered through Covered California or by Medi-Cal include the same comprehensive set of benefits known as "essential health benefits.”
  • What do "essential health benefits" consist of?
    Outpatient (Ambulatory) services Emergency services Hospitalization Maternity and Newborn care Mental Health and Substance Use Disorder Services, including Behavioral Health Treatment Prescription Drugs Programs such as physical and occupational therapy (known as Rehabilitative & Habilitative Services) and devices Laboratory services Preventive and wellness services & chronic disease management Children’s (Pediatric) services, including oral and vision care.
  • What health plans are available through Medi-Cal?
    Medi-Cal managed care offers a selection of 21 health plans. Your health plan options will vary depending upon the county in which you live. Most counties offer commercial plans, which also operate in Covered California including Anthem Blue Cross, Kaiser, Health Net, and Molina. Other plans are public plans administered by the community. Every county’s Medi-Cal plans provide the same high quality care at the same low or no cost to Californians, no matter where you live. The directory of health plans available through Medi-Cal managed care is available online at: Medi-Cal Managed Care: Health Plan Directory.​
  • Is there a deadline to enroll in Medi-Cal?
    No. There is no deadline to enroll in Medi-Cal. You can apply at any time during the year. When you are determined eligible for Medi-Cal, your eligibility goes back to the month of your application. In some cases, you may be able to receive Medi-Cal coverage right away. Contact your county human services agency at County Offices for more information. However, enrollment in Covered California only occurs during an open enrollment paper, so if you are trying to enroll some household members in Medi-Cal and others in Covered California, be sure to enroll in time for the households seeking coverage through Covered California.​
  • If someone's Medi-Cal coverage is cancelled due to increased income or decreased household size, does that person qualify for special enrollment into Covered California?
    Yes, losing health coverage such as Medi-Cal is considered a qualifying event that would trigger a special enrollment period. Other qualifying events include: Permanently moved to/within California Lost or will soon lose their health insurance, including Medi-Cal eligibility (also known as loss of Minimal Essential Coverage (MEC) Had a baby or adopted a child Got married or entered into a domestic partnership Domestic violence survivors (If married, abuser’s income not counted if survivor lives apart and is unable to file joint tax return.) Returned from active duty military service Released from jail or prison Gained citizenship/lawful presence Federally Recognized American Indian/ Alaska Native Other qualifying events as identified on the Covered California portal
  • If I sign up for Medi-Cal, will anything happen to my assets?
    Medi-Cal only tries to recover its costs for medical assistance after your death when a recipient is over age 55, or when a member of any age is cared for at an institution, such as a nursing home. Medi-Cal does not seek payment during your lifetime or the lifetimes of your surviving spouse, disabled son or daughter, or while your child is under 21 years of age. If you are under 55, you can sign up for Medi-Cal knowing that nothing will happen to your assets unless you are institutionalized. For those over age 55 or in an institution, the Department of Health Care Services may present a claim for the cost of your care. It would be paid from your estate at the time of your death. For more information, please visit Third Party Liability.​
  • Is it possible for the members of the same family to qualify for different coverage at the same time?
    The Covered California application is a single application for multiple health coverage programs. It is common that members of the same family or tax household are eligible for different programs. For example, both parents could be eligible for tax credits through Covered California, while the children are eligible for Medi-Cal. This is because the eligibility rules for Medi-Cal kids are different than for adults, which ensures that no child lacks affordable coverage. In other cases, one parent may be eligible for Covered California without subsidies because they have access to affordable coverage through their job, while their spouse is eligible for premium assistance tax credits through Covered California and the children are eligible for Medi-Cal. ​
  • My Medi-Cal has been discontinued and I am now able to enroll in Covered California during a Special Enrollment Period (SEP), how can I avoid a gap in my health coverage? ​
    If your Medi-Cal will be or has been discontinued, in order to avoid a gap in your health coverage, you should pick a Covered California plan before the date your Medi-Cal ends. If you do not select a Covered California plan in the same month your Medi-Cal ends, you will not have health care coverage for at least a month. You must also pay your Covered California premium by the due date when you are billed in order to be covered. If your request for enrollment is completed within 60 days of the qualifying life event date, the soonest your Covered California health plan can start will be the 1st of the month following your Covered California plan selection. If you wait more than 60 days after your Medi-Cal ends to pick a Covered California plan, you may not be able to enroll until Covered California’s next Open Enrollment Period.
  • Will my family and I qualify for the same program?
    Depending on your household size or family income, you or your family may qualify for different programs. For example, you may qualify for affordable private health insurance available through Covered California. However, your child may qualify for free Medi-Cal. We will tell you which health insurance you and other members qualify for.​
  • I just found out I am pregnant. Can I apply for health insurance that will cover me during my pregnancy?
    Yes. Make sure to answer yes to the application question “Are you pregnant?” or tell the person helping you to fill out your application. You can apply for health insurance that can cover pre-natal care, labor and delivery, and postpartum care. Health insurance plans can no longer deny health insurance if you are pregnant.​
  • I just had a new baby. What should I do about health insurance?​​​
    If you did not have Medi-Cal or the Medi-Cal Access Program at the time of delivery, fill out this application for your newborn. If you did have Medi-Cal or the Medi-Cal Access Program during your pregnancy, you do not need to fill out this application. Call your county worker to make sure your baby is covered from birth, or fill out a newborn referral form. Print the MC 330 form. If you had coverage under the Medi-Cal Access Program download an Infant Registration Form, or call, 1-800-433-2611.​​​​​
  • Does everyone on the application have to be a U.S. citizen or U.S. national?
    No. You may qualify for health insurance through Medi-Cal even if you are not a U.S. citizen or a U.S. national.
  • Will I qualify for health insurance if I am not a citizen or do not have satisfactory immigration status?
    You do not have to be a citizen or have satisfactory immigration status to qualify for Medi-Cal.You may qualify for Medi-Cal coverage of emergency and pregnancy-related services if you meet all of the eligibility requirements but do not have a satisfactory immigration status.Immigrants who have a satisfactory immigration status and meet all eligibility requirements can qualify for full Medi-Cal coverage.
  • Will undocumented immigrants be eligible for full-scope Medi-Cal?
    An immigrant who meets all eligibility requirements, but is not in a satisfactory immigration status for full scope Medi-Cal is entitled to emergency and pregnancy-related services and, when needed, state-funded long-term care.
  • Will the information I provide for health coverage be used to verify my immigration status?
    Immigration status is verified for documented immigrants who want Medi-Cal and claim to be in a satisfactory immigration status for full scope Medi-Cal.This information is only used to verify status for Medi-Cal eligibility purposes.
  • Can people on H-1 visas, including those who have lived legally in the country for fewer than 5 years, enroll in Medi-Cal?
    Yes. In general, anyone can apply for Medi-C​​al. A person on an H1 visa is a temporary worker or trainee. As long as they are living and working in California and provide evidence of that, they can meet California residency. If they meet all other eligibility requirements, they will be eligible for restricted scope Medi-Cal limited to emergency and pregnancy related services. It does not matter how long they have lived in the United States. If they meet all eligibility requirements they will be eligible for restricted scope Medi-Cal.
  • Can green card holders, including those who have lived legally in the US for fewer than 5 years, enroll in Medi-Cal?
    Yes. A lawful permanent resident (green card holder) is eligible for Medi-Cal regardless of their date of entry if they meet all other eligibility requirements. Under current Medi-Cal policy, eligible green card holders get full scope Medi-Cal in California even if they have been in the United States for less than 5 years. ​
  • Can I get health insurance even if my income is too high?
    Yes. Any Californian who qualifies can purchase private health insurance through Covered California regardless of income. We use your income to help us find the health insurance that is most affordable for your family.
  • What if my income changes after I apply for health coverage?
    If your income changes, it may change what kind of health insurance you qualify for. If you have private health insurance through Covered California, call to report any change in your income that may affect your eligibility within 30 days. If you have Medi-Cal and your income changes, contact your county social services office within 10 days.
  • If an adult is claimed as a tax dependent by their parents, will their parents income count towards the dependent adult’s income for eligibility?
    Yes. The adult who expects to be claimed as a tax dependent by his/her parents will have his parents income counted when determining income eligibility under the MAGI methodology.
  • If my income changes, how will the change affect me when I file my taxes?
    It is important to report income changes to Covered California that impact the amount of premium assistance (or tax credits) that you receive. If your income decreases, you may qualify to receive a higher amount of premium assistance and reduce your out-of-pocket expenses even more. However, if your income increases, you may receive too much premium assistance and may be required to repay some of it back when you file your taxes for the benefit year.
  • What if I didn’t file taxes last year?
    If you didn't file taxes last year, you can still apply for health insurance and get premium assistance. We will use your income to help us find the health insurance that is most affordable for you and your family. If you qualify for premium assistance, you must file taxes for the benefit year.
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