Medi Cal Eligibility and Procedures
How to Apply for Medi Cal
California's Medicaid program, Medi-Cal, provides free or discounted insurance for low-income people in the state. Even though it can seem difficult to get approved for Medi-Cal, it is relatively simple to apply for it, as you can do it online, by mail, or in person. Start by seeing if you're eligible for the program. California has a streamlined application for health insurance online. It tells you if you're eligible for Medi-Cal, but it will also let you know if you're eligible for other low-cost insurance.
Meeting the Eligibility Requirements
Calculate your total income for the year.Your total income includes any income from jobs, pensions, Social Security, and alimony. Add in any other money you made from things like the lottery or legal gambling.
- If your income changes month to month, take a monthly estimate by adding it altogether for the year and dividing by 12.
Determine your household size.Count yourself, your spouse (if you're married), and anyone you can claim as a dependent on your taxes. So if you are married to someone and have 3 kids, your household size is 5. Keep in mind that the income of anyone you claim as a dependent counts towards your income.
Use the poverty chart to determine your eligibility.The eligibility level differs based on what criteria you meet, but if you're an adult who's not pregnant, you must make below or at 138% of the federal poverty line. You can find the chart here: .
- In 2019, 138% of the federal poverty line for a 1-person household is ,754 USD. For a 2-person household, it's ,715 USD. The poverty line changes each year according to federal guidelines.
- If you're pregnant, you must be between 213% and 322% of the poverty line, which is ,060 to ,002 USD for 2 people in 2019.
- For kids, they must be at or below 266% of the federal poverty line to qualify, so your kids may qualify if you don't. For a 2-person household, 266% of the federal poverty line is ,784 USD.
Fill in the Shop and Compare tool to find programs you're eligible for.If you can't figure it out with the chart, this tool just asks for some basic information to help determine what you qualify for. Fill in your income, household size, and year you want coverage for, as well as your zip code. You can find the form at .
- Plus, you can also use it to apply for coverage in the following year.
Applying through Covered California
Visit the Covered California website.The website is . Under "Get Coverage," click on "Start an Application." Click "Apply Now." This will bring up a page to create a registration for the website.
Register for the website with a username and password.Click on "Create an Account," and enter your name, birthday, Social Security Number, and an email, phone number, or address. You'll also need a 4-digit pin number. You will need to create a username for the website. It can simply be a combination of your first and last name if you'd like. Then enter a password that you can remember.
- The password must meet 3 of the 4 following criteria: have an uppercase letter, have a lowercase letter, contain a number, and/or contain a special character.
Fill in your basic biographical information.Add your name, address, and your phone number. Include your Social Security Number, as well as your preferred language and preferred contact method.
Add basic medical information about yourself.Answer questions about yourself, such as whether you're blind or disabled. You will be asked questions about your age, and whether you've ever been in the foster system, just to name a few.
- Be ready to provide detailed information about your jobs and income.
- You'll also be asked optional questions about your race.
Include information about each person you're applying for.Fill in the same medical and background information for each person included in the application. For instance, you may need to fill in the information for your spouse and/or your children.
- If they have income, you will need to fill in that information, too.
Sign and submit the application online.The system will ask you to verify that the information you're submitting is truthful, via an e-signature. Then, you can submit the application by hitting the "Submit" button.
- If you need help, click the "Need Help?" at the top right-hand corner of the screen.
Wait for a letter in the mail.Within 45 days, you should get a letter in the mail notifying what coverage you can receive. They will tell you if you qualify for Medi-Cal or another form of coverage.
- If the state needs more information from you, they will contact you.
Filling in a Paper Application
Find the paper application online.Download the application from this link: . Print it off so you can fill it in.
Write in your basic biographical information.Add information about your address, phone number, and Social Security Number. You'll also need to write your preferred method of communication and your preferred language.
Put in medical information for you and anyone else you're applying for.Fill in basic information, such as whether you are disabled or blind. Add in detailed information about your current jobs and income.
- Add the same information for your spouse and dependents. If you need to add information for more than 4 people (including yourself), copy pages 6-8 for each extra person.
Read your rights and responsibilities and sign the form.There's a section laying out your rights and responsibilities that you should read through, as it provides information you need to know. Sign and date the application when you're done.
- If you need help, call 1-800-300-1506 (TTY: 1-888-889-4500). The help line is open from 8 a.m. to 8 p.m. Monday through Friday and 8 a.m. to 6 p.m. on Saturday.
Send in your application even if you can't complete all of it.Once you sign and send in your form, someone will contact you to help you finish it. The most important thing is to just get as much information as you can down and then send it in.
- Mail your application in to:
P.O. Box 989725
West Sacramento, CA 95798-9725
- You can also walk it into your local county services office, which you can find at .
- Mail your application in to:
Expect a reply within 45 days.You will get a letter in the mail with a response to your application. They will notify if you've been accepted to Medi-Cal.
- If you haven't heard back from the state in that time, call your local office. You can find the number here: .
Filling in an Application in Person
Find your local county office.They are listed alphabetically at . You'll find contact information and an address for each office, as well as a website.
Click on the website for your local office.Look on the website for more information about your local office. You can find office hours, as well as any information you may need to make an appointment.
- Make an appointment if the local office asks you to.
Visit the office in person.Go to the closest office and ask for an application for Medi-Cal. They should have paper applications on hand, as well as people there to assist you with any help you may need.
Fill in the needed information.Add your main biographical information, including your name, Social Security Number, address, and phone number. You will also need to fill in basic medical information and details on income for you and every other dependent in your household.
- You will also need to fill in the information for your spouse if you're married.
Sign and turn in the application.Date the application, as well. If someone at the office filled it in for you, you'll still need to sign it to show that you asked for that assistance.
- Wait 45 days for a reply in the mail.
QuestionMy mother suffers from severe dementia, and is currently in a self-pay assisted living facility. Her private assets will run out in less than 4 months due to the high cost of her care. When can we apply for Medi Cal so that her current assets do not disqualify her coverage?wikiHow ContributorCommunity AnswerImmediately. It takes a while for the insurance to kick in. If she hasn't started collecting disability, file for that right away as well. Take any payments you have made to both places, they may reimburse you for payments made, depending which state you live in.Thanks!
QuestionWill I lose my food stamps if I leave the area to find cheaper housing?wikiHow ContributorCommunity AnswerNot necessarily. You should be able to find a state assistance office near wherever you are living. You can probably find the address for the nearest one to you, online. Then you just go there and reapply. If you move to somewhere within the same city you are living in now, you shouldn't have to reapply at all. You would just need to contact the office you went to when at your old address, and let them know you moved.They will tell you what to do next.Thanks!
QuestionHow long do I need to live in California to get Medi Cal?wikiHow ContributorCommunity AnswerCalifornia has a number of welfare programs, such as CalFresh. CalWORKS and Medi-Cal, that provide services for limited income residents. The counties administer the programs. It is possible to be eligible to qualify for one of the welfare programs within a day after arriving in California.Thanks!
QuestionI forgot the answers to the questions for my password reset. What can I do?wikiHow ContributorCommunity AnswerClick on the "forgot my password" and click for the option for a code to be transmitted to you via text message or voice mail to your phone. When you receive the code, type it in where requested and then you should be able to reset your password and change your challenge questions. You will get am email about such a request and a password change to ensure that it was you that made the changes and not someone else.Thanks!
QuestionIs payment required for care received prior to a person's death if he dies?wikiHow ContributorCommunity AnswerMedical bills will arrive whether or not the patient survives. If necessary, seek legal assistance to help sort payment.Thanks!
Can an 18 year old who is living on their own apply for Medi Cal?
Can I turn in an application for Medi-Cal without adding my signature or signing it?
Do I need a valid California ID or license to apply for Medi-Cal?
How do I apply for medical for another person?
How many months of bank records are required?
- If you're turned down for Medi-Cal, you can appeal the decision within 90 days of being notified. To appeal, notify someone in the state program. Tell them you'd like a review of the decision.
Video: Q & A Session: Medi-Cal Benefits & Application Process in California
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