How To Qualify & Apply for Medi-Cal in California

How do I apply for Medi-Cal in California? What documents do I need to apply for Medi-Cal? How long does it take to get approved for Medi-Cal? If you have these questions and others about California Medicaid, we can help. In this post, we will explain in detail how to qualify and apply for California Medicaid benefits.

Also, we will answer the most frequently asked questions about California Medi-Cal, including documents you need to apply for Medi-Cal.

Table of Contents:

What is Medi-Cal?
California Medi-Cal Eligibility
How to Apply for Medi-Cal
FAQs on How to apply for Medi-Cal in California:
Is there a list of documents I need to apply for Medi-Cal?
What Happens After I apply for Medi-Cal Benefits?
How do I Choose a Medi-Cal Plan?
What is the difference in coverage between Medi-Cal and Covered California?
What health plans are available through Medi-Cal?
Can I get a Ride to my Medi-Cal Appointments?
Does Medi-Cal Cover Dental?

What is Medi-Cal?

Medi-Cal is California’s version of the Federal Medicaid program. Medi-Cal offers no-cost and low-cost health coverage to eligible people who live in California.

The Department of Health Care Services (DHCS) oversees the Medi-Cal program.

Generally, the county social services office manages most Medi-Cal cases for DHCS.

Medi-Cal has always covered low-income children, pregnant women, and families.

On Jan. 1, 2014, California expanded Medi-Cal eligibility to include low-income adults with incomes below 138% of the federal poverty level (FPL).

California Medi-Cal Eligibility

There are three ways you can qualify for Medi-Cal:

First, you can qualify if you meet the income limits.

To see if you qualify based on income, look at the chart below. Income numbers are based on your monthly or yearly earnings.

Second, you can also get Medi-Cal if you are:

65 or older
Blind
Disabled
Under 21
Pregnant
In a skilled nursing or intermediate care home
On refugee status for a limited time, depending on how long you have been in the United States
A parent or caretaker relative of an age-eligible child

Additionally, there are special Medi-Cal programs for individuals who:

Have been screened for breast and/or cervical cancer (Breast and Cervical Cancer Treatment Program)
Have tuberculosis (for citizens and documented non-citizens only)
Receives Medicare (for payment of the Medicare premium)
Are minors in need of confidential treatment for drug and/or alcohol abuse, sexually transmitted diseases, sexual abuse, pregnancy, family planning, or mental illness
Have had an organ transplant in the previous two years and need anti-rejection medication

Third, if you are enrolled in one of the following programs, you can also get Medi-Cal:

CalFresh
SSI/SSP
CalWorks (AFDC)
Refugee Assistance
Foster Care or Adoption Assistance Program

What is the Maximum Income to Qualify for Medi-Cal?

To qualify for Medi-Cal based on income, you cannot make more than the income guidelines for that year.

Adults ages 21-64 whose income is at or below 138% of the Federal Poverty Level may qualify for Medi-Cal under Medicaid Expansion.

See our Medi-Cal income limits for 2022 guide for income limits for all Medi-Cal eligible categories.

How to Apply for Medi-Cal

You can apply for Medi-Cal year-round.

There are four ways to apply for Medi-Cal in California:

Option 1 – In Person

Apply for Medi-Cal at your Local County Services Office, where you can get personal help completing your application.

Option 2 – By Mail

Download a Medi-Cal application, available in English and other languages, through the Single Streamlined Application, which you can find here.

Send the completed and signed application to the address provided on the form.

Option 3 – By Phone

You can also apply for Medi-Cal over the phone, by calling your Local County Services Office.

Option 4 – Online

The fastest way to apply for Medi-Cal is online. Here, you have two options:

You can apply for Medi-Cal online through Benefitscal.com.

In addition, you can sign up for Medi-Cal online through Covered California.

CoveredCA.com is a joint partnership between Covered California and the Department of Health Care Services.

Apply for Medi-Cal by County

You can also view our guide on how to apply for Medi-Cal by county – listed alphabetically:

FAQs on How to apply for Medi-Cal in California

Here are the most frequently asked questions about Medi-Cal applications in California:

Is there a list of documents I need to apply for Medi-Cal?

Yes. When you apply for Medi-Cal, you’ll need to provide the information below for all household members.

Identification – Driver’s license, California ID card, passport, birth certificates, or proof of immigration status
Social Security numbers for applicants who have them or are eligible to have them
Proof of residency – Rent or mortgage receipt or utility bill
Proof of income – Pay stubs, Social Security award letter, child support and alimony, unemployment/disability stubs, or Veterans benefits
Tax filing information for anyone in the household who files taxes or is claimed as a dependent (you don’t have to file taxes to qualify for Medi-Cal)
Property ownership for those applying on the basis of age (65+) or disability

What Happens After I apply for Medi-Cal Benefits?

It takes about 45 days from the date you submit your Medi-Cal application for the county office to make a decision.

Here’s what the process generally looks like:

Apply – complete the Medi-Cal application, and submit it either in person, by mail, by phone, or online.
Receive a Notification of Likely Eligibility by mail from your county’s social services office.
Your county’s social services office may contact you by mail or by phone to request paper verification if income, citizenship, and other criteria cannot be verified electronically
Receive Final Notice of Action notifying you of whether or not you can receive Medi-Cal
Receive your BIC – when you receive your BIC in the mail, you are able to use the many Medi-Cal benefits available to you.

How do I Choose a Medi-Cal Plan?

When you are first approved for Medi-Cal and receive your BIC, you are covered under Fee-for-Service (also called Regular Medi-Cal).

Within 45 days of receiving your BIC, you will be mailed information explaining your health plan options.

However, you must choose a health plan within 30 days of receiving your health plan information mailer.

If you do not choose a plan within 30 days, Medi-Cal will choose a plan for you.

The Medi-Cal health plans available to you depend on what county you live in.

Here’s how to choose a Medi-Cal provider near you:

To locate a Medi-Cal provider near you, click here to search the database of providers.

Once you are on the website, select a program (see image below), provider type, and then by address, zip code, or county.

Tips to keep in mind when choosing a Medi-Cal Provider:

If you see only one health plan listed for your county, it means the county has chosen this plan for you. Please wait for your health plan information in the mail.

However, if you see multiple health plans listed, please explore each plan, and choose the one that suits you and your family’s needs.

Remember, if you do not choose a plan within 30 days of receiving your health plan information mailer, Medi-Cal will choose a plan for you.

Also, If you live in San Benito County, there is only one health plan available and you may enroll in this health plan.

However, you may choose to stay with Fee-for-Service Medi-Cal.

What is the difference in coverage between Medi-Cal and Covered California?

Medi-Cal offers low-cost or free health coverage to eligible Californian residents with limited income.

Covered California is the state’s health insurance marketplace where Californians can shop for health plans and access financial assistance if they qualify for it.

All of the health plans offered through Covered California or by Medi-Cal include the same comprehensive set of benefits known as “essential health benefits.”

Essential health benefits consist of:

Outpatient (Ambulatory) services
Emergency services
Hospitalization
Maternity and Newborn care
Mental Health and Substance Use Disorder Services, including Behavioral Health Treatment
Prescription Drugs
Programs such as physical and occupational therapy (known as Rehabilitative & Habilitative Services) and devices
Laboratory services
Preventive and wellness services & chronic disease management
Children’s (Pediatric) services, including oral and vision care.

What health plans are available through Medi-Cal?

Medi-Cal managed care offers a selection of 21 health plans.

Your health plan options will vary depending upon the county in which you live.

Most counties offer commercial plans, which also operate in Covered California including providers like Anthem Blue Cross, Kaiser, Health Net, and Molina.

Other plans are public plans administered by the community.

The directory of health plans available through Medi-Cal managed care is available online here.

Can I get a Ride to my Medi-Cal Appointments?

Yes, Medi-Cal can help with rides to medical, mental health, substance use, or dental appointments when those appointments are covered by Medi-Cal.

The rides can be either nonmedical transportation (NMT) or non-emergency medical transportation (NEMT).

You can also use NMT if you need to pick up prescriptions or medical supplies or equipment.

If you can travel by car, bus, train, or taxi, but do not have a ride to your appointment, NMT can be arranged.

Also, if you are enrolled in a Medi-Cal health plan, call your Member Services for information on how to get NMT services.

Does Medi-Cal Cover Dental?

Yes, Medi-Cal offers comprehensive preventative and restorative dental benefits to both children and adults.

For details about what dental benefits are covered by Medi-Cal, see our Medi-Cal Dental Guide.

What is IHSS Program?

The IHSS program provides those with limited income who are disabled, blind, or over the age of 65 with in-home care services to help them remain safely at home.

How to Apply for Medi-Cal in California Summary

We hope this post on How to Apply for Medi-Cal in California was helpful.

Questions?

If you have further questions about Medi-Cal, please let us know in the comments section below.

Be sure to check out our other articles about Medicaid, including: