Medi-Cal California Medicaid | Health for California

Medi-Cal health insurance coverage through Health for California

medi-cal is california’s medicaid program that provides medical services to low-income people at little or no cost. It is administered by the Centers for Medicare and Medicaid Services (CMS) and the California Department of Health Care Services (DHCs).

Reading: What does medi-cal insurance cover

what is medi-cal?

Each state administers part of the Medicaid health care program, and Medi-Cal is the version available to qualified individuals in California. With Medicaid for California, if you qualify and apply, it can help pay for doctor visits, medications, dental exams, rehabilitation, surgery, hospital visits, and more.

who is responsible for medi-cal?

12 million california residents are enrolled in medi-cal

county human services departments are responsible for administering the medi-cal program at the local level. Recent reports indicate that more than 14 million Californians are eligible to enroll in Medi-Cal. Approximately one-third of the state’s population is enrolled in Medi-Cal. over 80% of members are covered through the managed care plan, while the rest use a fee-for-service system to access care.

getting started with medi-cal enrollment

if you are eligible for medi-cal, health for california can help you with your application. We’ll help you request a quote online, and our simple request is fast and accurate, so you’ll get the information you need right away. if you need coverage and may qualify for medi-cal or would like to compare plans, get a quote from us.

how do i apply for medi-cal?

You have several options if you want to apply for medi-cal. The first step is usually to determine if you are eligible for coverage. To do this, look at your household income or review any other programs you qualify for in California.

If you meet the income requirements or are eligible due to health or age, you can apply for coverage in the following ways:

  • by mail
  • in person
  • online
  • what do I need to apply?

    When you apply, you will need to provide information about yourself and your family. Some of the details you will be asked for include:

    • Social Security Numbers: You will need the social security number of each person in your family or those who are part of the application. if you are an immigrant without a social security number, you will need to provide your document information instead.
    • Employment Data: You must provide information about your employment status and income with your application. If more than one person in the household works, please provide employment details for each person, as their income may affect your overall eligibility.
    • Federal tax information: You will also need to provide your federal tax details, such as your filing status and the number of dependents you claim on your return.
    • Other Health Insurance: If you have health insurance through a job or other insurance policy, you will be asked to include information about it on your application.
    • It is important to provide as much of the requested information as possible when submitting your application. not having certain details, like your tax information or employment information, does not mean you should not apply. It is often better to submit your application with all the information you need than not to apply at all. In fact, you can still get coverage for your children even if you are an undocumented immigrant. You may also be eligible for coverage even if you don’t file a tax return.

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      what’s in the application?

      As you fill out the application, you will be asked to provide personal information about everyone in your household. the app will ask for the following:

      • address
      • preferred language
      • if you or other members of your family have a disability
      • citizenship or immigration status
      • employment and income information
      • race and ethnicity
      • veteran status
      • birthday
      • if you are confused about any of the questions on the application or need help, health for california is here to help. If you know you’re eligible for Medi-Cal, it may be worth applying anyway, as you may qualify for a subsidized health insurance plan if you don’t ultimately qualify for Medi-Cal.

        medi-cal insurance: understanding the basics

        California has the largest Medicaid program in the country. There was a huge increase in Medi-Cal enrollment in large part due to the expansion that California opted for after the Affordable Care Act was passed that provides help to a wider range of people. Now, people with slightly higher incomes can get care regardless of their disability, family status, financial resources, and other factors that were typically considered in eligibility decisions.

        medi-cal for immigrants

        As of May 1, 2016, California’s low-income undocumented children (under age 19) have access to comprehensive coverage through Medi-Cal.

        Most undocumented adults do not qualify for medi-cal. however, they may qualify for some coverage during pregnancy or emergencies.

        In most cases, adults who are immigrants and have been legal residents for at least five years or meet other requirements qualify for Medi-Cal. however, even immigrants who are legal residents but do not qualify for medi-cal may qualify for assistance in obtaining insurance if they are at or below 400 percent of the fpl (federal poverty level).

        what can medi-cal cover?

        medi-cal provides a variety of health benefits, including the following 10 “essential health benefits” required by the Affordable Care Act for all health plans:

        • 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 rehabilitation and habilitation services) and devices
        • laboratory services
        • preventive and wellness services and chronic disease management
        • services for children, including oral and vision care
        • understand your medi-cal benefits

          Health for California can help you understand your medi-cal benefits

          your medi-cal benefits will depend on how you qualify for medi-cal. some patients get full medi-cal, which means they qualify for full medi-cal coverage. some patients eligible for partial scope medi-cal will be covered for only some services. it’s important to understand what is covered and what may not be covered for you.

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          The Medi-Cal Health Benefits Chart provides more detail on specific services in the above categories. Medi-Cal also offers certain dental benefits for adults and children, and full-scope Medi-Cal members receive vision benefits.

          your medi-cal benefits will depend on how you qualify for medi-cal. some patients get full medi-cal, which means they qualify for full medi-cal coverage. some patients eligible for partial scope medi-cal will be covered for only some services. it’s important to understand what is covered and what may not be covered for you.

          medi-cal also offers certain dental benefits for adults and children, and full-scope medi-cal members receive vision benefits.

          to improve its services, dhcs states that to improve members’ access to services and ensure they spend tax dollars efficiently, “nearly 80 percent of their members now receive care from a plan medi-cal managed care. under these models, access to health care is easier and the quality of care improves.”*

          how do you get medical care with medi-cal

          Plan options vary depending on the county in which you reside. Most counties offer commercial plans, including Anthem Blue Cross, Kaiser Permanente, Health Net, and Molina. other counties offer community-managed public plans. If a county administers only one plan, all Medi-Cal members will enroll in that plan. Nearly all Medi-Cal plans are “managed care plans,” meaning they work similar to an HMO. medi-cal plans can be found in the medi-cal managed care health plan directory.

          A managed care plan means you’ll have a primary care doctor, and he’s the only person you’ll see if you need medical care. if you need to see another doctor or specialist, your primary care doctor must refer you to that health care provider if you want medi-cal to cover that visit. however, in an emergency, you are not limited to a specific hospital.

          after you have selected a plan

          once the plan is selected, a doctor or group of doctors must be chosen. medi-cal members must use a medi-cal doctor and facility that are in the group and plan in which they are enrolled. members can search for medi-cal doctors on the medi-cal managed care health care options website.

          In some areas, only “fee-for-service” medi-cal is offered; contact medi-cal to find out how fee-for-service medi-cal works.

          the future is here

          California dhcs seeks to fulfill its vital role as california’s health care safety net by having the following mission and vision:

          “…provide Californians with access to high-quality, affordable health care, including medical, dental, mental health, substance use disorder, and long-term services and supports…and to preserve and improve health physical and mental health of all Californians.” *

          if you’re ready to sign up for medi-cal or another health insurance program, get a california health quote today. our online application is simple and accurate, allowing you to apply for coverage from the comfort of your home or anywhere you want.

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