The program that pays for low-cost health care in California is changing. It’s important to ensure your county office has your most recent contact information, or you could lose coverage unnecessarily.
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What is Medi-Cal?
Medi-Cal is California’s health care coverage program for low-income individuals and families. The program pays for various health services, including hospital visits, doctor’s appointments, medicine, dental care, and eyeglasses. Eligibility is based on your income, whether you live alone or with others in the household, and whether you are disabled. The program also considers your family size and whether you are a US citizen. Since 2011, Medi-Cal has been moving beneficiaries into managed care. The ACA’s Bridge to Reform waiver authorized the program to impact more beneficiaries into managed care than previously allowed. You may have to pay an enrollment fee when you join one of these managed care plans. You may also be required to pay a monthly premium.
Medi-Cal Eligibility
If you have a low income, there are ways you can qualify for Medi-Cal insurance to pay for health care. The main requirement is income, but you may also need to meet other eligibility requirements like age, blindness or disability, pregnancy, residence in a nursing home, temporary refugee status or parenthood. To be eligible for Medi-Cal, you must provide documentary evidence of your income, including pay stubs and W-2 forms. If your income changes during the year, it may affect what levels of Obamacare subsidies you can get through Covered California and how much your Medi-Cal benefits will increase. Over the next 14 months, Medi-Cal will send renewal packets to about 15 million current enrollees. These packets will include a Medi-Cal annual redetermination form, which asks beneficiaries to update their income, living arrangements and eligibility information. Getting these forms is key to avoiding disrupting your healthcare and coverage.
Medi-Cal Benefits
The program pays for various health services, from well-baby visits and checkups to dental cleanings and eye exams. It also helps pay for prescriptions and other medications you need but can’t afford. You can get more information about the benefits of Medi-Cal by visiting the Medi-Cal website(link is external) or by contacting your local county office. You may need to renew your coverage if you are a current Medi-Cal beneficiary and your circumstances have changed since the COVID-19 public health emergency ended. It’s important to keep your contact information and family size current. People with incomes below the poverty level can enroll in Medi-Cal through Covered California, a free service that works with your county social services agency to find the best health plan for you. You can use Shop and Compare to find plans that fit your budget and needs, including coverage with a doctor in your network. Covered California can also help you decline Medi-Cal and pick a different health plan if you qualify for financial assistance through the federal program.
Medi-Cal Rules
Whether you have been on Medi-Cal for decades or joined during the pandemic, starting April 1, you must undergo a redetermination process to see if you qualify for continued coverage.
The redetermination process will differ from the annual renewal that most Californians are used to. This year, you will be asked to choose a Medi-Cal managed care health plan (a “health maintenance organization”) that best fits your needs. The available programs vary by county, ranging from for-profit to county-run private-public partnerships. This pub gives tips on how to select a plan and explains what the options are. It also tells you how to raise any issues with a plan through your doctor or customer service. If you are found to be no longer eligible for full-scope Medi-Cal, the pub explains how to apply for subsidized private insurance through Covered California. If you are still determining if you qualify for Medi-Cal, this pub tells you how to find out by filling out a Covered California application and submitting federal tax information.
Medi-Cal Subscription Service
DHCS has launched a new subscription service for providers, allowing them to receive links to News articles, Medi-Cal Update bulletins and System Status Alerts via email. Subscribers can select one or more subject matters of interest and will receive monthly emails with links to the relevant articles shortly after they post to the provider’s website. Medi-Cal is California’s health program for people with limited income and resources. The program provides free or low-cost medical and dental services for children, adults, and seniors. It also covers some long-term care services and support for adults with disabilities. Medi-Cal is the country’s earliest and largest Medicaid-managed care program, covering about 10 million people in California. Its unique structure results from underlying differences in the history and traditions of healthcare systems in different counties across the state. As other Medicaid programs increasingly move to risk-based managed care, examining California’s experiences is informative and instructive.