General
Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income. Medicaid is a state and federal program that provides health coverage for individuals, families and children if you have a very low income. Medi-Cal is California’s Medicaid program that offers low-cost or free health coverage to eligible Californian residents with limited income.
No. Medi-Cal programs are actually expanding (learn more about the expansion of Medi-Cal here). During the COVID-19 emergency, Medi-Cal enrollees were protected from losing their coverage (except for a few exceptions, such as moving out of state). This Medi-Cal protection ended on March 31, 2023.
If you set up an online account at benefitscal.com, you can check in your account when your yellow renewal comes up. Make sure your current contact information is updated with your local county office, if it has changed. Get Help
No. Renewing and enrolling is always free, including community assistance with enrolling and renewing.
No. Please take a look at the Public Charge Roadmap for more information
The information is based on data provided in the initial application and updated by the county reviewing other state and federal databases.
Medi-Cal will never ask for money to turn in a renewal. If you get a call asking for money to complete your renewal, report it. Please call the Medi-Cal fraud hotline at 1-800-822-6222.
Moving
No. Medi-Cal will only cover limited services such as emergency room services. You should contact your county social services office and inform them if your child moves out of state. He/she will need to apply for affordable health care such as Medicaid in the new state where the college is located to have access to full health care coverage. It is important to note that different states have different eligibility criteria for Medicaid. Therefore, just because your child may be eligible for Medicaid in California does not necessarily mean they will be eligible for Medicaid in the new state.
You should notify your local county social services office that your son/daughter is temporarily moving to attend college and provide the child’s address in the new county. The county will update the case records with the new address and county code in the State’s database for your child.
In counties where there are choices of Medi-Cal managed care plans, Health Care Options will mail the health plan enrollment information to your son/daughter’s new address explaining the health plan options available in the new county of residence. If your child does not choose a new health plan during a specified time period of up to 45 days, your child will be defaulted into a plan. In order to prevent a delay in the new health plan enrollment, your child should contact Health Care Options at 1-800-430-4263 for assistance with health plan enrollment.
Transportation
When there is a medical emergency, people are usually taken to the hospital by ambulance. “Emergency services” are defined by the state of California as “services needed to relieve severe pain or to diagnose and treat unexpected medical conditions that, if not diagnosed and treated right away, would lead to disability or death.” Medi-Cal covers the lowest cost type of medical transportation that meets the individual’s medical needs.
For emergency medical transportation, you don’t need to get permission ahead of time, but there are some billing standards for Medi-Cal, like an emergency statement.
Providers of emergency medical transportation are expected to include this statement with every reimbursement claim they send in. The statement must include the nature of the situation, the name of the hospital to which the enrollee was taken, and the name of the doctor who is taking care of the enrollee. A doctor’s signature is not needed.
Medi-Cal also covers non-medical transportation to and from medical visits.Ask your Medi-Cal health plan to help you arrange this transportation. For more information visit the DHCS webpage on Transportation:
Eligibility by Income
Medi-Cal eligibility is based on your current monthly household income.
Covered California financial assistance is based on what you expect your household income will be for the coverage year, (not last year’s income).
When you calculate your income, you’ll need to include the incomes of you, your spouse, and anyone you claim as a dependent when you file taxes.
You can start by using your adjusted gross income (AGI) from your most recent federal income tax return, located on line 11 on the Form 1040. Add any foreign income, Social Security benefits and interest that are tax-exempt. Then, add or subtract any income changes you expect in the next year.
Some people have unpredictable incomes, especially those who are self-employed, seasonally employed, or unemployed. If that is your situation, it’s best to estimate your current household income as accurately as possible, and then report changes in income throughout the year in your account.
For more FAQs please visit https://www.dhcs.ca.gov/provgovpart/Pages/FAQs.aspx