How to Get California Medicaid Benefits

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This article is a collection of the best answers to California Medicaid’s most frequently asked questions.

Medicaid is a government-sponsored healthcare program for low-income families and individuals who fulfill specific income and resource requirements. Only the aged, blind, or disabled can access resources within the defined restrictions.

We have scoured the internet to provide all you need to know about the California Medicaid Benefits.

You will learn everything you need to know about California Medicaid in this article.

What is the California Medical Program (Medi-Cal)?

Medi-Cal is California’s Medicaid health care program. This program is set to pay for many medical services for adults and children who have limited resources and income.

Many different programs are available under Medi-Cal to assist Californians in various family and medical circumstances.

Medi-Cal has taken over the California Healthy Families program effective January 1, 2013.

Who is eligible for the California Medicaid Program?

California Medicaid eligibility is available to residents of California, citizens, permanent residents, legal aliens in need of insurance/health care, and those with very low or poor incomes. A member of any of these groups is also required. 

  • Pregnant 
  • Being responsible for a child of age 21 or younger
  • Blind
  • Being disabled or having a disabled family member in your household
  • Be 65 years of age or older.

Annual Household Income Limits (before taxes)

Household Size*Maximum Income Level (Per Year)
1$18,075
2$24,353
3$30,630
4$36,908
5$43,186
6$49,463
7$55,741
8$62,018

*Add an additional $6,2677 per person for households that have more than eight people

How do I contact Medicaid in California?

You can contact California Medicaid in the following ways.

Phone

800-541-5555

Program Contact

1-800-786-4346

Website

Medi-Cal    

Covered California

What are the Medicaid plans in California?

California started providing Medicaid plans in 1972 and there are 6 different plans that are being offered all over the state.:

  • County Organized Health Systems (COHS)
  • Two-Plan Model
  • Geographic Managed Care Model
  • Regional
  • Imperial 
  • San Benito 
California Medicaid

What is covered by California Medicaid?

The following services are covered by California Medicaid

AcupunctureLaboratory services
Allergy careMaternity and newborn care
Ambulance servicesMental health services
Anesthesiologist servicesOrgan & tissue transplantation
Children’s pediatric servicesOrthotics/prostheses
ChiropracticOutpatient (ambulatory) services
DentalPhysician services
Dialysis/hemodialysisPodiatry
Emergency room servicesPrescription drugs
Emergency servicesPreventive and wellness services
Family planning servicesRehabilitative services and devices
Hearing aidsSmoking cessation services
Home health servicesSurgical services
HospitalizationTreatment therapies
Inpatient hospital servicesVision

Copayments for California Medicaid

Most people who enroll in MediCal have no premium or copayment, and no out-of-pocket cost.

Some Medi-Cal families may pay a premium of $13 per child, up to a maximum family of $39 per monthly.

California Medicaid Waivers

Medi-Cal waivers provide additional services for specific groups, limit services in different areas and offer medical coverage to people who don’t fulfull the requirements of traditional Medicaid coverage.

Certain waivers provide services to assist with family planning and prevention of pregnancy. They also offer personal care resources that enable disabled adults to stay in their homes. Freedom of Choice Waivers provides mental health services to beneficiaries with certain diagnoses.

Contact your local social services office to get access to some waiver services.

To determine eligibility for others, an assessment must take place through the program administrator. To participate in any waiver, you must be eligible for Medi-Cal.

Does the disabled person get California Medicaid?

Services are available for people who are disabled, and require Home and Community-Based Services. Such services are available for the elderly, for Medi-Cal beneficiaries who have mid – late-stage AIDS or for those who require assisted living, and for developmentally disabled people.

Is Medicaid and Medi-Cal the same?

Medi-Cal is part of Medicaid in California. Each state runs its own Medicaid program. Different states follow different national rules for Medicaid, but they are allowed to run their programs in their own way

Is Medi-Cal the same as Medicare?

Medicare and Medi-Cal are two separate programs for health care coverage. Medicare is available nationally to cover people over the age of 65, and people under 65 who have with certain disabilities. Medi-Cal is California’s Medicaid program, covering low-income individuals and families in California.

What is the highest income limit for California Medicaid?

The income limits based on household size are: 

  • One person: $17,609. 
  • Two people: $23,792. 
  • Three people: $​​29,974.

Who is not eligible for Medi-Cal?

Young adults and non-documented children below the age 25 can be eligible for coverage if they meet all other eligibility requirements.

But non-documented people above the age of 25 cannot be eligible for full coverage, they can only qualify during pregnancy or in emergencies.

Can I have both Alaska Medicaid and Medicare?

If you are 65 or older, you can qualify for both Medicare and Medicaid. If your age is below 65 then you can only avail the benefits of Medicaid, if other eligibility criteria are also fulfilled.

How much money can you have in the bank on California Medicaid?

Check your countable assets to see if you qualify for any one of the programs. The taxable asset limit will go upwards of $130,000 for a single individual, $195,000 for couples.

Will you still have California Medicaid once you are over 18?

California passed a new law that allows people to be fully covered till the age of 26, keeping in mind that they meet the eligibility criteria. Their status of immigration will not matter.

What is the best Medicaid in California?

RatingPlan NameConsumer Satisfaction
3.5Molina Healthcare of California Partner Plan Inc.1.5
3.0Blue Cross of California Partnership Plan1.5
3.0Blue Shield of California Promise Health Plan2.0
3.0California Health & Wellness2.5

Where can I upload the documents for California Medicaid?

You can do it in the following ways:

  1. Sign in to your account at coveredca.
  2. Click on the link where it says view actions needed.
  3. Click the “Upload Document” button.
  4. Select the type of document you want to upload.
  5. You can only upload the document for only one household member, or you can choose to upload the document for multiple members if applicable.
  6. A text will appear saying the date and time of your uploaded document, it will confirm that your document is uploaded
  7. Make sure that you have uploaded the correct document by clicking the view option.
  8. After you have reviewed everything, click the submit button.

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Editor
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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