FYI for Medi-cal Eligibility
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What Is Medi-Cal?
Medi-Cal, called Medicaid in other states, is California’s health care program. It pays for a variety of medical services for children and adults who have limited resources and income. How Can Medi-Cal Help You? Medi-Cal is a large program made up of many separate programs to assist Californians in various medical situations. Some Medi-Cal covered services include doctor visits, hospitalization, nursing home care, dental, glasses, and prescriptions. When you apply, an Eligibility Technician will determine if you are eligible and which program is best for you and your family. Once enrolled, you will continue to receive Medi-Cal as long as you meet the eligibility requirements. |
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Who Is Eligible to Receive Medi-Cal Benefits? Families with children• • Persons under 21 or 65 years of age and older • Pregnant women • Blind and disabled persons • Recipients of nursing home or long term care • Refugees
You are automatically eligible to Medi-Cal if you are receiving cash assistance under one of these programs: • SSI/SSP (Supplemental Security Income/State Supplemental Program) • CalWORKs (California Work Opportunity and Responsibility to Kids) • Foster Care or Adoption Assistance Program • Refugee Assistance |
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Is Medi-Cal Free or Do I Have to Pay for It? Depending on your monthly income, your family size and the Medi-Cal program you are eligible to, you may have to pay some of your health care bills each month before Medi-Cal pays for any expense. This is called a "share of cost". You do not pay for Medi-Cal in months you don’t use it. Can I Apply for Medi-Cal if I Own a Home and a Car? The home you live in is not counted in your asset limit. One car may be exempt. Your asset limit is based on family size. |
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Can I Have Private Health Insurance or HMO Coverage and Also Be On Medi-Cal? Yes. But you are required to report other private health insurance or HMO coverage you have. Generally, your other insurance will be billed first before Medi-Cal. |
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Do I Have To Be A U.S. Citizen to Get Medi-Cal? No. Your citizenship and immigration status affects what Medi-Cal services you can receive. U.S. citizens, legal permanent residents, and most other legal immigrants qualify for the full range of Medi-Cal benefits. Can an Undocumented Person Get Medi-Cal? Yes. If you are undocumented and meet all other Medi-Cal eligibility requirements, you can receive "restricted" Medi-Cal. This covers only emergency and pregnancy-related services. Can I Apply for Retroactive Medi-Cal? Yes. You can apply and be evaluated for any of the three months immediately preceding the month of application. You may need to provide verification of income and property for each month requested. How Do I Receive Medi-Cal Services? In Orange County most beneficiaries receive their Medi-Cal services through the CalOptima system, either under a health plan or CalOptima Direct. |
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