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 Sacramento, 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 Sacramento County – including who is eligible for Medi-Cal, Medi-Cal income limits, how to apply for benefits, Department of Human Assistance (DHA) contact information, and Medi-Cal providers in Sacramento County, including Kaiser Permanente, Aetna Better Health of California and 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 Sacramento County.
Additionally, we will provide DHA contact information, including the phone number and hours of operation.
Lastly, we will answer the most frequently asked questions about Medi-Cal in Sacramento County, including what Medi-Cal covers.
Table of Contents:
- What is Medi-Cal
- What services are covered by Medi-Cal?
- Medi-Cal in Sacramento County
- Medi-Cal Expansion in California
- Who is Eligible for Medi-Cal?
- Sacramento County Medi-Cal Income Limits
- How to Apply for California Medi-Cal in Sacramento County
- Apply for and Manage Medi-Cal Benefits Online
- Sacramento County Medi-Cal Office Locations
- Sacramento County Medi-Cal Phone Number
- Medi-Cal Managed Care Health Plans in Sacramento County
- Medi-Cal Providers in Sacramento County, California
- Sacramento 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 Sacramento County
In Sacramento County, the Medi-Cal program is managed by the Department of Human Assistance (DHA).
In addition to Medi-Cal benefits, the DHA also handles CalFresh, CalWORKs, and General Relief applications and benefits.
Furthermore, MyBenefits Calwin is the website for Sacramento 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
Sacramento County Medi-Cal Income Limits
The Sacramento 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 Sacramento County
There are three ways to apply for Medi-Cal in Sacramento County:
- Online at MyBenefits CalWIN
- Online through Covered California, at or by calling 1-800-300-1506.
- Call the Department of Human Assistance (DHA) during business hours Monday – Friday 8:00 am – 4:00 pm at (916)874-3100 or (209)744-0499.
- Apply in person at one of the DHA office locations listed below.
Apply for and Manage Medi-Cal Benefits Online
The MyBenefits CalWIN website is a fast, easy way for Orange 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.
Sacramento County Medi-Cal Office Locations
Applications for the Medi-Cal Program can be completed in person at a DHA office location.
To begin the process you will need to locate the DHA 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 DHA office locations in Sacramento County:
2700 Fulton Ave.
Sacramento, CA 95821
3960 Research Dr.
Sacramento, CA 95838
1725 28th St
Sacramento, CA 95816
2450 Florin Road
Sacramento, CA 95822
210 North Lincoln Way Galt, CA 95632
5747 Watt Ave.
North Highlands, CA 95660
Sacramento County Medi-Cal Phone Number
Here’s the phone number to call to speak to a live person regarding Medi-Cal in Sacramento County:
Call the Department of Human Assistance (DHA) during business hours Monday – Friday 8:00 am – 4:00 pm at (916)874-3100 or (209)744-0499.
Medi-Cal Managed Care Health Plans in Sacramento 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 Sacramento County, California.
| Plan Name | Phone Number | |
|---|---|---|
| Aetna Better Health of California | (855) 772-9076 | (855) 772-9076 (TTY 711) |
| Anthem Blue Cross Partnership Plan | (800) 407-4627 TTY/TDD (888) 757-6034 |
|
| Health Net Community Solutions, Inc. | (800) 675-6110) TTY/TDD (800) 431-0964 |
|
| Kaiser Permanente | (800) 464-4000 English (800) 788-0616 Spanish (800) 757-7585 Chinese Dialects TTY/TDD (800) 777-1370 |
|
| Molina Healthcare of California Partner Plan, Inc. | (888) 665-4621 TTY/TDD (800) 479-3310 |
|
| Specialty Health Plan | ||
| InnovAge California PACE – Sacramento | 916-603-5400 | |
| Sutter Senior Care (PACE) | (833) 560-7223 TTY/TDD (916) 887-5890 |
Medi-Cal Providers in Sacramento 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 Sacramento County FAQs
Here are some of the most frequently asked questions about Medi-Cal in Sacramento County:
What are the Medi-Cal Income Eligibility Requirements for Immigrants?
For most immigrants enrolling in Medi-Cal, the limit to qualify for Medi-Cal is 138% of the federal poverty level.
Additionally, eligibility takes into account income and household size.
Also, Certain groups like pregnant women qualify at slightly higher incomes.
Below are the 2022 California Medi-Cal income limits for adults based on household size.
| Family Size | Monthly Income Limit (138% of FPL) | Annual Income Limit (138% of FPL) |
| 1 | $1,564 | $18,755 |
| 2 | $2,106 | $25,268 |
| 2 Adults | $2,106 | $25,268 |
| 3 | $2,650 | $31,782 |
| 4 | $3,192 | $38,295 |
| 5 | $3,735 | $44,809 |
| 6 | $4,278 | $51,323 |
| 7 | $4,821 | $57,836 |
| 8 | $5,363 | $64,350 |
For income limits for other Medi-Cal eligible groups in California, see our Medi-Cal in California income limit guide.
How do I choose a Medi-Cal Health Plan in Sacramento 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 I find a Specialist that takes Medi-Cal?
You can see a Specialist under Medi-Cal. However, you may need pre-approval from your health plan.
Depending on when you live in California, it may be hard to find specialists that take Medi-Cal. Also, there may be long waiting lists.
In a Medi-Cal Health Plan, if you have trouble finding a specialist, your Plan must help you find one.
Also, remember that before you see a specialist, you may need to get pre-approval. Check with your doctor or your MediCal Health Plan.
To get the names of specialists ask, your doctor, hospital, clinic, or your Medi-Cal Health Plan.
What Is Covered California?
Covered California is California’s health insurance marketplace. This marketplace enables individuals to purchase insurance at a subsidized rate.
What Is The Difference Between Covered California & Medi-Cal?
Health insurances from Medi-Cal and Covered California both cover essential benefits. This includes”
- Ambulatory services
- Hospitalization
- Prescriptions
- Laboratory services
- Behavioral health care, and other treatments.
Eligibility for both programs is based on income and family size.
Individuals who qualify for Medi-Cal will pay little to no money for their health insurance.
Additionally, premiums for health insurance purchased through Covered California vary and are dependent on age, income, family size, and zip code.
What type of insurance will I get through Covered California?
Covered California health plans have 4 different levels of coverage:
- Bronze (60%)
- Silver (70%)
- Gold (80%)
- Platinum (90%)
Additionally, there are enhanced silver plans available for those with eligible income, with coverage at 73%, 87%, and 94%.
What If I Miss The Covered California Enrollment Deadline?
You may be eligible for a special enrollment period if you have a qualifying life event such as:
- Losing health coverage
- A change in income
- Change in residency
- Other personal circumstances
Your coverage will begin the first day of the month following enrollment, if you enroll prior to the 15th day of the month.
If you enroll after the 15th of the month, your health coverage will begin the first day of the second month after enrollment.
How much does IHSS pay in California?
IHSS Service providers are paid an hourly rate set by Medi-Cal for their county.
As of 2021, these rates are between $14.00 and $17.50 / hour.
In general, the value of the services provided through the IHSS program will not exceed $3,500 per month.
On average, an IHSS provider is paid closer to $2,200 per month.
How do I Report Medi-Cal Fraud?
Call the Medi-Cal Fraud Hotline at 1-800-822-6222.
When you call, make sure you know the types of fraud you are reporting – see above for examples/types of Medi-Cal fraud.
The Department of Health Care Services (DHCS) asks that anyone suspecting Medi-Cal fraud, waste, or abuse to call the DHCS Medi-Cal Fraud Hotline at 1-800-822-6222.
If you feel this is an Emergency please call 911 for immediate assistance.
The call is free and the caller may remain anonymous.
The recorded message may be heard in 10 other languages: Spanish, Vietnamese, Cantonese, Armenian, Hmong, Cambodian, Laotian, Farsi, Korean, and Russian.
Medi-Cal in Sacramento County Summary
We hope this post on Medi-Cal in Sacramento County was helpful.
Questions?
If you have further questions about Medi-Cal in Sacramento 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:
