 | | | Medi-Cal (General): Frequently Asked Questions | | | | | | | | |
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1) What is the Medi-Cal program? |
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Medi-Cal is health coverage funded by both California and the federal government. It covers children, the aged, disabled, Supplemental Security Income (SSI) recipients, and other low-income or medically needy people. Medi-Cal is California's Medicaid program. |
2) What is the difference between the California Medi-Cal program and the federal Medicaid program? |
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California’s Medicaid program is Medi-Cal.
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3) How do I qualify for Medi-Cal? |
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You can qualify for Medi-Cal by meeting the requirements of a Medi-Cal eligibility category, which are also called programs. There are many Medi-Cal programs, and each has unique rules. Db101 gives detailed explanations of the following Medi-Cal programs:
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SSI-Linked
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Aged & Disabled Federal Poverty Level
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250% Working Disabled
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Aged, Blind, & Disabled - Medically Needy
To learn about other eligibility categories, speak with a benefits planner or Medi-Cal eligibility worker.
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4) What benefits does Medi-Cal provide? |
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Medi-Cal provides coverage for doctor visits, hospital stays, prescription drugs, rehabilitation, and other medical services. Some Medi-Cal programs provide access to all of these services (full-scope Medi-Cal), while others only provide some of them (partial-scope Medi-Cal). For a more detailed list of Medi-Cal services, see the glossary definition of full-scope Medi-Cal. In certain situations, Medi-Cal may pay for Medicare or private health insurance premiums. See Other Medi-Cal services for more details.
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5) How do I apply for Medi-Cal? |
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The application process depends on which Medi-Cal program you qualify for. For SSI-Linked Medi-Cal, you only need to apply for SSI by contacting your local Social Security office or by calling 1-800-772-1213 (voice), 1-800-325-0778 (TTY). For most other Medi-Cal programs, contact your local county welfare office. You can also download an application, (available in 11 languages) but you will need to submit it in person or by U.S. mail.
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6) What if I lose my Medi-Cal eligibility? |
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There are a number of ways to protect your Medi-Cal coverage. You may first want to consider switching eligibility categories. For example, if you lose your Medi-Cal because your income from a new job is too high, you may want to consider the 250% California Working Disabled program.
If you're on SSI, there are two programs that can help you keep your Medi-Cal when your countable income goes above the limit. If it's too high because you return to work, the 1619(b) provisions protect your Medi-Cal. If it goes above the limit because of an SSDI cost of living increase and you lose your SSI, the Pickle Amendment allows you to keep your Medi-Cal.
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