Medi-Cal is the Medicaid program in California. It provides health coverage to people with low income and asset levels who meet certain eligibility requirements. If you live in the County of El Dorado, California, and need help with Medi-Cal, we can help. In this post, we will review everything you need to know about Medi-Cal in El Dorado County – including who is eligible for Medi-Cal, Medi-Cal income limits, how to apply for benefits, Department of Human Services (DHS) contact information, and Medi-Cal providers in El Dorado County, including Anthem Blue Cross Partnership Plan.
Before we get into Medi-Cal eligibility guidelines, first, we will explain what Medi-Cal is about and California’s Medicaid expansion.
Next, we will explain the Medi-Cal eligibility guidelines in detail, including the income limit, which is the most important.
We will then walk you through the 3 ways you can apply for Medi-Cal in El Dorado County.
Additionally, we will provide DHS contact information, including the phone number and hours of operation.
Lastly, we will answer the most frequently asked questions about Medi-Cal in El Dorado County, including what Medi-Cal covers.
Table of Contents:
- What is Medi-Cal
- What services are covered by Medi-Cal?
- Medi-Cal in El Dorado County
- Medi-Cal Expansion in California
- Who is Eligible for Medi-Cal?
- El Dorado County Medi-Cal Income Limits
- How to Apply for California Medi-Cal in El Dorado County
- Apply for and Manage Medi-Cal Benefits Online
- El Dorado County Medi-Cal Office Locations
- El Dorado County Medi-Cal Phone Number
- Medi-Cal Managed Care Health Plans in El Dorado County
- Medi-Cal Providers in El Dorado County, California
- El Dorado County Medi-Cal FAQs
What is Medi-Cal
Medi-Cal is California’s Medicaid public health insurance program. Medi-Cal provides free or low-cost medical services for children and adults with limited income (and limited resources for some Medi-Cal programs).
The program is supported by federal and state taxes.
Effective January 1, 2014, the Affordable Care Act (ACA) expanded Medi-Cal coverage to previously ineligible adults (childless, non-disabled, non-elderly).
Medi-Cal Program and Services include:
- Children and Adults
- Seniors and Persons with Disabilities
- Teen Services
- Newborn Referral
- Long Term Care
What services are covered by Medi-Cal?
- Outpatient (ambulatory) services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services/devices (physical and occupational therapy)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Certain adult dental services
- Pediatric services, including dental and vision care
Medi-Cal in El Dorado County
In El Dorado County, the Medi-Cal program is managed by the Department of Human Services (DHS).
In addition to Medi-Cal benefits, the DHS also handles CalFresh, CalWORKs, and General Relief applications and benefits.
Furthermore, BenefitsCal is the website for El Dorado County Residents to apply for and to view their benefits online.
Continue reading below for BenefitsCal account information.
Medi-Cal Expansion in California
Effective January 1, 2014, The Affordable Care Act (ACA) expanded Medicaid benefits to low-income, childless adults between the ages of 19-64 who meet the low or no income requirements.
Also, starting on January 1, 2020, a new law in California gave full-scope Medi-Cal to young adults under the age of 26, and immigration status does not matter.
This is referred to as the Young Adult Expansion. All other Medi-Cal eligibility rules, including income limits, will still apply.
Furthermore, beginning May 1, 2022, a new law in California will give full-scope Medi-Cal to adults 50 years of age or older and immigration status does not matter.
This is referred to as the Older Adult Expansion. All other Medi-Cal eligibility rules, including income limits, will still apply to this new group.
Who is Eligible for Medi-Cal?
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 annual or yearly earnings.
Second, you can also get Medi-Cal if you are:
- 65 or older
- Under 21
- 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
- Have been screened for breast and/or cervical cancer (Breast and Cervical Cancer Treatment Program)
Third, if you are enrolled in one of the following programs, you can also get Medi-Cal:
- CalWorks (AFDC)
- Refugee Assistance
- Foster Care or Adoption Assistance Program
El Dorado County Medi-Cal Income Limits
The El Dorado County Medi-Cal income limit follows the California Medi-Cal Income Limit and is calculated as a percentage of the Federal Poverty Line (FPL).
To be eligible for Medi-Cal, you cannot make more than the income guidelines outlined below:
- Children up to age 1 with family income up to 266 percent of FPL
- Any child age 1-5 with a family income up to 266 percent of FPL
- Children ages 6- 18 with family income up to 266 percent of FPL
- CHIP for children with family income up to 266%-322% percent of FPL
- Pregnant women with family income up to 213 percent of FPL
- Parents of minor children with family income up to 114 percent of FPL
- Individuals who are elderly, blind, and disabled with family income up to 100% of the FPL
- Adults without dependents under Medicaid expansion with income up to 138% of the FPL
Medi-Cal income limit charts
Below are the California Medi-Cal income limit charts, one showing eligibility for children and the other showing eligibility for adults.
First is the income limit for children by age category.
Find the age category your child falls into and you will see the income limit by household size.
|California Medicaid Income Limit – Children|
|Children Medicaid Ages 0-1||Children Medicaid Ages 1-5||Children Medicaid Ages 6-18||Children Separate CHIP|
Next, you will find below the income limit for adults by category.
Find the category you fall into and you will see the income limit by household size.
|California Medicaid Income Limit – Adults|
|Pregnant Women Medicaid||Adults (Medicaid) Parent/ Caretaker||Seniors & People w/ Disabilities (Medicaid)||Adults (Medicaid) Expansion to Adults|
How to Apply for California Medi-Cal in El Dorado County
There are three ways to apply for Medi-Cal in El Dorado County:
- Online at BenefitsCal.com.
- Online through Covered California, at or by calling 1-800-300-1506.
- Call the Department of Human Services (DHS) during business hours Monday – Friday 7:00 am – 5:00 pm at – call (530) 642-7300 in Placerville or (530) 573-3200 in South Lake Tahoe.
- Apply in person at one of the DHS office locations listed below.
Apply for and Manage Medi-Cal Benefits Online
The BenefitsCal website is the fast, easy way for El Dorado County residents to apply for and manage public assistance services online, including Medi-Cal.
With a BenefitsCal account, you can perform the following tasks online:
- See if you are eligible for Medi-Cal and other benefits
- Apply for Medi-Cal, CalFresh, and Cash Assistance Benefits
- Report Changes in your Household situation that may affect your benefits
- Renew your Medi-Cal, CalFresh, and Cash Assistance Benefits
If you currently have a BenefitsCal account, click here to log in and apply for or manage your Medi-Cal benefits.
However, if you do not currently have a BenefitsCal, click here to sign up for one. It only takes a few minutes.
The video below does a great job of explaining in detail how to sign up for a BenefitsCal account, and apply for and manage your benefits online.
We recommend watching the video in order to save time in navigating the BenefitsCal website.
El Dorado County Medi-Cal Office Locations
Applications for the Medi-Cal Program can be completed in person at a DHS office location.
To begin the process you will need to locate the DHS that serves your area.
Unless there is an emergent need for medical care, benefits may not be issued on the same day.
In addition to Medi-Cal, households can apply for CalFresh, General Relief, and CalWORKs at the following locations, which are open from 8 a.m. to 5 p.m. Monday through Friday:
See below for a list of DHS office locations in El Dorado County:
3057 Briw Road
Placerville, CA 95667
South Lake Tahoe Office
3368 Sandy Way
South Lake Tahoe, CA 96150
El Dorado County Medi-Cal Phone Number
Here’s the phone number to call to speak to a live person regarding Medi-Cal in El Dorado County:
Call the Department of Human Services (DHS) during business hours Monday – Friday 9:00 am – 5:00 pm at the numbers below:
Placerville – call (530) 642-7300, or
South Lake Tahoe – call (530) 573-3200.
Medi-Cal Managed Care Health Plans in El Dorado County
When you first qualify for Medi-Cal, you are covered under Medi-Cal Fee-for-Service.
However, you must choose a health plan within 30 days. If you do not choose a plan within 30 days, the State will choose a plan for you.
If you find only one health plan, the county has chosen this plan for you. Please wait for your health plan information mailer in the mail.
If you find multiple health plans listed, please explore each plan and choose the one that suits you and your family’s needs.
Below is a list of Medi-Cal Managed Care Health Plan options available in El Dorado County, California.
|Plan Name||Phone Number|
|Anthem Blue Cross Partnership Plan||(800) 407-4627|
TTY/TDD (888) 757-6034
|California Health & Wellness||(877) 658-0305|
TTY/TDD (866) 274-6083
|Specialty Health Plan|||
|InnovAge California PACE – Sacramento||916-603-5400|
Medi-Cal Providers in El Dorado County, California
When you enroll in (join) a Medi-Cal plan, you must choose a primary care provider (PCP).
Your PCP is the doctor or clinic you go to when you are sick or need a checkup.
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) to search for doctors, dentists, hospitals, medical clinics, and dental clinics near you.
Medi-Cal El Dorado County FAQs
Here are some of the most frequently asked questions about Medi-Cal in El Dorado County:
What Documents do I need to apply for Medi-Cal?
As part of the Medi-Cal application process, you should have the following documents available depending on your situation:
- Government-issued identification (Driver’s License, ID Cards, or Military ID)
- Resident Alien Card (Green Card) if applicable
- Social Security Cards or numbers
- Paystubs and/or latest tax records
- Proof of pregnancy, if applicable
- 65yrs and older, call our office for a list of required documents
How do I choose a Medi-Cal Health Plan in El Dorado County?
To enroll in a Health Plan, call Health Care Options at 1-800-430-4263 and enroll on the phone.
Alternatively, you can use the enrollment form that came in the envelope that was mailed to you with your Medi-Cal approval notice.
Note that 15 – 45 days after you enroll, your new Health Plan will send you a membership card.
While you are waiting for the membership card, keep using the doctors and hospitals you use now.
How do you get emergency or urgent care if you are outside of El Dorado County?
If you are outside of El Dorado and have an emergency or need urgent care:
- Call 911 or go to the nearest hospital emergency room or urgent care center.
- If you are not sure if it is an emergency or if you need urgent care, call your doctor or health network.
- Show your Medi-Cal ID card when you go to the hospital emergency room or urgent care center.
- Ask the hospital or urgent care center staff to call your Medi-Cal health plan’s Customer Service department within 24 hours.
What is the difference between no-cost Medi-Cal and share of cost Medi-Cal?
If you qualify for no-cost Medi-Cal, you will receive Medi-Cal services at no cost to you.
However, with share of cost (SOC) Medi-Cal, you will pay a certain amount only in the month you have medical expenses.
The amount of your share of cost depends on your income and resources.
What programs are available to help me get health insurance?
People who need health insurance in California may be able to get help in one of these ways:
Help with Healthcare Premium
Premium assistance is available to help make health insurance affordable.
People who qualify for premium assistance may take them in advance (before they file taxes) to make their monthly premiums lower.
Additionally, they can take them at the end of the year and pay less in taxes.
However, the amount of assistance for monthly premiums depends upon your household size and family income.
Help Through Medi-Cal
Medi-Cal is California’s Medicaid public health insurance program.
The program provides free or low-cost medical services for children and adults with limited income (and resources for some Medi-Cal programs).
It’s health insurance for low-income California residents who meet certain requirements.
If your income is within the Medi-Cal limits for your family size, you will receive Medi-Cal coverage at no cost to you.
Additionally, the Medi-Cal share of cost (SOC) program extends Medi-Cal eligibility to low-income older adults and people with disabilities who have significant health care needs but are just above the free Medi-Cal income limit.
Medi-Cal in El Dorado County Summary
We hope this post on Medi-Cal in El Dorado County was helpful.
If you have further questions about Medi-Cal in El Dorado County, please let us know in the comments section below.
Be sure to check out our other articles about Medi-Cal and California Medicaid program, including: