Medi-Cal
What is Medi-Cal?
Medi-Cal is California"s part of a national health coverage program called Medicaid.
Medi-Cal is a program that pays medical expenses for people with low income. This includes people who are aged, disabled, or have high medical costs. If you meet the requirements of the program, Medi-Cal will help pay for doctor visits, hospital stays, prescription drugs, rehabilitation, and other medical services.
Who is eligible for Medi-Cal?
You can qualify for Medi-Cal in many different ways. These different ways are called eligibility categories. For example, SSI-Linked Medi-Cal is an eligibility category that allows people who qualify for SSI to automatically get Medi-Cal. There are over 90 eligibility categories, each with its own rules and requirements. Once you meet the requirements of an eligibility category, you are eligible for either full or partial-scope Medi-Cal.
Following describes the most common eligibility categories for people with disabilities:
- If your family has income at or below 138% of the Federal Poverty Level (FPL) (266% of FPL if you're a child), you may be eligible for Income-Based Medi-Cal
- If you qualify for SSI (Supplemental Security Income), you are automatically eligible for SSI-Linked Medi-Cal
- If you are aged or disabled, you may be eligible for Aged & Disabled Federal Poverty Level Medi-Cal
- If you are disabled and working, you may be eligible for California's Working Disabled Program. You will have to pay a small premium for Medi-Cal coverage, but you can have countable income up to 250% of FPL
- If you are aged, blind, or disabled, but your income is too high for other Medi-Cal programs, you may be eligible for Aged, Blind, and Disabled – Medically Needy Medi-Cal. For this program, you may need to spend a certain amount of your own money before Medi-Cal begins to pay for medical services. This payment is called a share of cost.
What services does Medi-Cal provide?
Primary Medical Care
- Doctor visits
- Diagnostic testing
- Emergency services
- Surgery
- Hospitalization
- Prescription drugs
- Dental services
- Health screenings for kids
Ongoing Care & Recovery
- Personal care services (IHSS)
- Occupational & physical therapy
- Outpatient drug abuse services
- Nursing facility stays
- Adult day health care
Other medical related costs
- Medical supplies
- Durable medical equipment
- Transportation to doctor visits
- Transportation costs for children with disabilities
How to apply?
- Online using BenefitsCal.
- Online using Covered California, an online one-stop shop where you can learn about your public and private health coverage options.
- In person at your local county social services agency.
- Using a paper application (available in 11 languages) and mailing it in to your local county social services agency.
Note: If you get Supplemental Security Income (SSI) or used to and now are on SSI 1619(b), you automatically get Medi-Cal coverage. You do not need to apply for Medi-Cal.