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 Fresno, 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 Fresno County – including who is eligible for Medi-Cal, Medi-Cal income limits, how to apply for benefits, Department of Social Services (DSS) contact information, and Medi-Cal providers in Fresno County, including Anthem Blue Cross Partnership Plan and CalViva Health.
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 Fresno County.
Additionally, we will provide DSS contact information, including the phone number and hours of operation.
Lastly, we will answer the most frequently asked questions about Medi-Cal in Fresno County, including what Medi-Cal covers.
Table of Contents:
- What is Medi-Cal
- What services are covered by Medi-Cal?
- Medi-Cal in Fresno County
- Medi-Cal Expansion in California
- Who is Eligible for Medi-Cal?
- Fresno County Medi-Cal Income Limits
- How to Apply for California Medi-Cal in Fresno County
- Apply for and Manage Medi-Cal Benefits Online
- Fresno County Medi-Cal Office Locations
- Fresno County Medi-Cal Phone Number
- Medi-Cal Managed Care Health Plans in Fresno County
- Medi-Cal Providers in Fresno County, California
- Fresno 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
- Dental
What services are covered by Medi-Cal?
- Outpatient (ambulatory) services
- Emergency services
- Hospitalization
- 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 Fresno County
In Fresno County, the Medi-Cal program is managed by the Department of Social Services (DSS).
In addition to Medi-Cal benefits, the DSS also handles CalFresh, CalWORKs, and General Relief applications and benefits.
Furthermore, MyBenefits Calwin is the website for Fresno County Residents to apply for and to view their benefits online.
Continue reading below for MyBenefits Calwin 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
- 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
- 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:
- CalFresh
- SSI/SSP
- CalWorks (AFDC)
- Refugee Assistance
- Foster Care or Adoption Assistance Program
Fresno County Medi-Cal Income Limits
The Fresno 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 | |||
| % FPL | 100% | 266% | 266% | 266% | 322% | |
|
Household Size
|
1 | $14,580 | $38,783 | $38,783 | $38,783 | $46,948 |
| 2 | $19,720 | $52,455 | $52,455 | $52,455 | $63,498 | |
| 3 | $24,860 | $66,128 | $66,128 | $66,128 | $80,049 | |
| 4 | $30,000 | $79,800 | $79,800 | $79,800 | $96,600 | |
| 5 | $35,140 | $93,472 | $93,472 | $93,472 | $113,151 | |
| 6 | $40,280 | $107,145 | $107,145 | $107,145 | $129,702 | |
| 7 | $45,420 | $120,817 | $120,817 | $120,817 | $146,252 | |
| 8 | $50,560 | $134,490 | $134,490 | $134,490 | $162,803 | |
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 | |||
| % FPL | 100% | 213% | 114% | 100% | 138% | |
|
Household Size
|
1 | $14,580 | $31,055 | $16,621 | $14,580 | $20,120 |
| 2 | $19,720 | $42,004 | $22,481 | $19,720 | $27,214 | |
| 3 | $24,860 | $52,952 | $28,340 | $24,860 | $34,307 | |
| 4 | $30,000 | $63,900 | $34,200 | $30,000 | $41,400 | |
| 5 | $35,140 | $74,848 | $40,060 | $35,140 | $48,493 | |
| 6 | $40,280 | $85,796 | $45,919 | $40,280 | $55,586 | |
| 7 | $45,420 | $96,745 | $51,779 | $45,420 | $62,680 | |
| 8 | $50,560 | $107,693 | $57,638 | $50,560 | $69,773 | |
How to Apply for California Medi-Cal in Fresno County
There are three ways to apply for Medi-Cal in Fresno County:
- Online at MyBenefits CalWIN
- Online through Covered California, at or by calling 1-800-300-1506.
- Call the Department of Social Services (DSS) during business hours Monday – Friday 7:30 am – 3:30 pm at 1-855-832-8082.
- Apply in person at one of the DSS office locations listed below.
If you are applying by mail, you can send your signed and completed application to PO Box 1912, Fresno, CA 93718.
Apply for and Manage Medi-Cal Benefits Online
The MyBenefits CalWIN website is a fast, easy way for Fresno County residents to apply for and manage public assistance services online, including Medi-Cal.
With a MyBenefits CalWIN 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 MyBenefits CalWIN account, click here to log in and apply for or manage your Medi-Cal benefits.
However, if you do not currently have a MyBenefits CalWIN, 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 MyBenefits CalWIN account, and apply for and manage your benefits online.
We recommend watching the video in order to save time in navigating the MyBenefits CalWIN website.
Fresno County Medi-Cal Office Locations
Applications for the Medi-Cal Program can be completed in person at a DSS office location.
To begin the process you will need to locate the DSS 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 DSS office locations in Fresno County:
Clovis Campus – Building 1
Main Number: (559) 600-1DSS (1377)
Toll-free Number 1(877) 600-1377 / 1(855) 832-8082
Fax your application to (559) 600-7688 (if you live in the greater Fresno area)
Address: 3500 Never Forget Lane, Clovis, CA 93612
Fresno FAX Bus Route provides services to this building by using Route 28
Office Hours: 7:30 am to 3:30 pm
Coalinga Office
Main Number: (559) 600-6300
Fax your application to (559) 935-1604
Address: 311 Coalinga Plaza, Coalinga, CA 93210
Office Hours: 7:30 am to 3:30 pm
Kerman Regional Center
Main Number: 559 600-1DSS (1377)
Toll-free Number 1(877) 600-1377 / 1(855) 832-8082
Fax your application to (559) 600-7688
Address: 15180 W Whitesbridge, Kerman CA 93630
Office Hours: 7:30 a.m. to 3:30 pm
Reedley Regional Center
Main Number: (559) 600-9800
Fax your application to (559) 600-7747
Address: 1680 E Manning Ave, Reedley, CA 93654
Office Hours: 7:30 am to 3:30 pm
Selma Southeast Regional Center
Fax your application to (559) 600-7706
Address: 3830 McCall Ave, Selma, CA 93662
Office Hours: 7:30 am to 3:30 pm
West Fresno Regional Center
Main Number: (559) 600-1DSS (1377)
Toll-free Number 1(877) 600-1377 / 1(855) 832-8082
Fax your application to (559) 600-7688
Address: 142 E California. Fresno CA 93706
Office Hours: 7:30 a.m. to 3:30 pm
Fresno County Medi-Cal Phone Number
Here’s the phone number to call to speak to a live person regarding Medi-Cal in Fresno County:
Call the Department of Social Services (DSS) during business hours Monday – Friday 7:30 am – 3:30 pm at 1-855-832-8082.
Medi-Cal Managed Care Health Plans in Fresno 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 Fresno County, California.
| Plan Name | Phone Number |
|---|---|
| Anthem Blue Cross Partnership Plan | (800) 407-4627 TTY/TDD (888) 757-6034 |
| CalViva Health | (888) 893-1569 TTY/TDD (800) 431-0964 |
| Specialty Health Plan | |
| Fresno PACE | 559-400-6420TTY 559-442-0751 |
| Sequoia PACE | 800-637-3187
TTY |
Medi-Cal Providers in Fresno 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 Fresno County FAQs
Here are some of the most frequently asked questions about Medi-Cal in Fresno County:
How do I get a Replacement Benefits Identification Card?
Has your Medi-Cal Benefits Identification Card (BIC) been Damaged, Lost, Stolen, or Never Received?
To get help with a replacement, call the Fresno County Department of Social Services 24-hour service line at Phone 1-559-600-1377 or toll-free at Phone 1-855-832-8082 between 7:30 am – 3:30 pm, Monday-Friday.
Here’s what you need to know before you call:
First, If you did not receive your BIC or it is lost or stolen, you may ask for a BIC from the County Department of Social Services office.
However, if your BIC is stolen, you must tell your local police and the County Department of Social Services office.
You should them as much information about the theft as possible.
Also, if you are issued a new card, your old card will no longer be valid.
How do I choose a Medi-Cal Health Plan in Fresno 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.
What is Denti-Cal?
California’s Medicaid program, Medi-Cal, currently offers dental services as one of the program’s many benefits.
Medi-Cal Dental, also known as Denti-Cal, is a program that provides free or low-cost dental services to eligible children and adults.
Does Medi-Cal cover Dental Benefits?
Yes. The Medi-Cal Dental Program covers a variety of dental services for Medi-Cal beneficiaries, such as:
- Diagnostic and preventive dental hygiene (e.g. examinations, x-rays, and teeth cleanings);
- Emergency services for pain control;
- Tooth extractions;
- Fillings;
- Root canal treatments (anterior/posterior);
- Crowns (prefabricated/laboratory);
- Scaling and root planning;
- Periodontal maintenance;
- Complete and partial dentures; and
- Orthodontics for children who qualify.
For dental coverage for kids, see our Medi-Cal Dental for Kids Guide.
I Just Signed up for Medi-Cal Dental. What do I need to take to my Dental Visit?
When you visit the dentist, show your Medi-Cal Benefits Identification Card (BIC) to your dentist’s office at your appointment.
Your dentist will match the name and signature on your BIC with another form of identification, such as:
- Your Social Security Number (SSN)
- A valid California driver’s license
- Any identification card issued by the Department of Motor Vehicles (DMV)
- Or any other document which appears to prove your identity
If your photo ID has expired, the dental office will accept it up to six months from the expiration date.
In some cases, you can still be seen for dental services without a BIC.
Can I get Medi-Cal if I am not a Citizen?
It depends on your immigration status. Here’s what you need to know:
- If you have satisfactory Immigration Status and all other eligibility requirements are met, you may be eligible to Full-scope Benefits.
- If you have a non-satisfactory Immigration Status and all other eligibility requirements are met, you may be eligible to Restricted-scope Benefits.
- Children and adults under the age of 26 are eligible to Full-Scope Medi-Cal benefits regardless of their immigration status and if all other eligibility requirements are met.
Medi-Cal in Fresno County Summary
We hope this post on Medi-Cal in Fresno County was helpful.
Questions?
If you have further questions about Medi-Cal in Fresno 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:
