"Apply for and Renew Medi-Cal in San Diego County"

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 San Diego, 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 San Diego County – including who is eligible for Medi-Cal, Medi-Cal income limits, how to apply for benefits, Health and Human Services Agency (HHSA) contact information, and Medi-Cal providers in San Diego County, including CalOptima.

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 San Diego County.

Additionally, we will provide HHSA contact information, including the phone number and hours of operation.

Lastly, we will answer the most frequently asked questions about Medi-Cal in San Diego County, including what Medi-Cal covers.

"Medi-Cal in San Diego"

Table of Contents:

  • What is Medi-Cal
  • What services are covered by Medi-Cal?
  • Medi-Cal in San Diego County
  • Medi-Cal Expansion in California
  • Who is Eligible for Medi-Cal?
  • San Diego County Medi-Cal Income Limits
  • How to Apply for California Medi-Cal in San Diego County
  • Apply for and Manage Medi-Cal Benefits Online
  • San Diego County Medi-Cal Office Locations
  • San Diego County Medi-Cal Phone Number
  • Medi-Cal Managed Care Health Plans in San Diego County
  • Medi-Cal Providers in San Diego County, California
  • San Diego 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 San Diego County

In San Diego County, the Medi-Cal program is managed by the Health and Human Services Agency (HHSA).

In addition to Medi-Cal benefits, the HHSA also handles CalFresh, CalWORKs, and General Relief applications and benefits.

Furthermore, MyBenefits Calwin is the website for San Diego 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

San Diego County Medi-Cal Income Limits

The San Diego 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 0-1Children Medicaid Ages 1-5Children Medicaid Ages 6-18Children Separate CHIP
% FPL100%266%266%266%322%
Household Size
1$13,590$36,149$36,149$36,149$43,760
2$18,310$48,705$48,705$48,705$58,958
3$23,030$61,260$61,260$61,260$74,157
4$27,750$73,815$73,815$73,815$89,355
5$32,470$86,370$86,370$86,370$104,553
6$37,190$98,925$98,925$98,925$119,752
7$41,910$111,481$111,481$111,481$134,950
8$46,630$124,036$124,036$124,036$150,149

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 MedicaidAdults (Medicaid) Parent/ CaretakerSeniors & People w/ Disabilities (Medicaid)Adults (Medicaid) Expansion to Adults
% FPL100%213%114%100%138%
Household Size
1$13,590$28,947$15,493$13,590$18,754
2$18,310$39,000$20,873$18,310$25,268
3$23,030$49,054$26,254$23,030$31,781
4$27,750$59,108$31,635$27,750$38,295
5$32,470$69,161$37,016$32,470$44,809
6$37,190$79,215$42,397$37,190$51,322
7$41,910$89,268$47,777$41,910$57,836
8$46,630$99,322$53,158$46,630$64,349

How to Apply for California Medi-Cal in San Diego County

There are three ways to apply for Medi-Cal in San Diego County:

Additionally, you can mail in completed applications and verification documents to the following address:

County of San Diego
Health and Human Services Agency
APPLICATIONS
P.O. Box 939044
San Diego, CA 92193-9005

Apply for and Manage Medi-Cal Benefits Online

The MyBenefits CalWIN website is the fast, easy way for San Diego 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.

San Diego County Medi-Cal Office Locations

Applications for the Medi-Cal Program can be completed in person at an HHSA office location.

To begin the process you will need to locate the HHSA Family Resource Center that serves your area.

You should be prepared to spend a minimum of two hours at the Family Resource Center.

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 HHSA office locations in San Diego County:

You can pick up a Medi-Cal application at the following HHSA Family Resource Centers:

Centre City

1255 Imperial Avenue,
5th Floor,
San Diego, CA 92101

Phone: 1-866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

El Cajon

220 S. First Street,
El Cajon, CA 92019

Phone: 1-866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

Lemon Grove

7065 Broadway,
Lemon Grove, CA 91945

Phone: 1-866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

Central Region

1130 10th Avenue
San Diego, CA 92101

Phone: 1-866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

North Central

5055 Ruffin Road
San Diego, CA 92123

Phone: 1-866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

North Coastal

3708 Ocean Ranch Blvd,
Oceanside, CA 92056

Phone: 866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

North Inland

649 West Mission Avenue #3,
Escondido, CA 92025

Phone: 866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

South

690 Oxford Street
Chula Vista, CA 91911

Central

4588 Market Street,
San Diego, CA 92102

Phone: 866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

Additionally, you can pick up a Medi-Cal application at the following HHSA offices:

Fallbrook Community Resource Center

202 West College
Fallbrook, CA 92028

Phone:

866-262-9881

Hours: Monday – Friday, 7:00 am – 5:00 pm

Ramona Community Resource Center

1521 Main Street
Ramona, CA 92065

South Region Live Well Center at National City

401 Mile of Cars
National City, CA 91950

San Diego County Medi-Cal Phone Number

Here’s the phone number to call to speak to a live person regarding Medi-Cal in San Diego County:

Call the HHSA Access Call Center during business hours Monday – Friday 7:00 am – 5:00 pm at 1-866-262-9881.

Medi-Cal Managed Care Health Plans in San Diego 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 San Diego County, California.

Plan NamePhone Number
Aetna Better Health of California​(855) 772-9076 (TTY 711)
Blue Shield of California Promise Health Plan(800) 605-2556
TTY/TDD (800) 735-2929
Community Health Group Partnership Plan(800) 224-7766
TTY/TDD (800) 735-2929
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
UnitedHealthcare Community Plan​​​​(866) 270-5785/TTY: 711
Specialty Health Plan
Family Health Centers of San Diego(619) 515-2445.TTY: (833) 530-9622
Gary and Mary West PACE(760) 280-2230
​San Diego PACE(619) 205-4585
TTY: (800) 735-2922
St. Paul’s PACE(619) 677-3800
TTY/TDD (800) 735-2922

See our guide on getting a Medi-Cal plan through Kaiser Permanente.

Medi-Cal Providers in San Diego 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 Providers in California"

Medi-Cal San Diego County FAQs

Here are some of the most frequently asked questions about Medi-Cal in San Diego County:

What is included in the 2020 California Medi-Cal expansion?

In 2020, California expanded full-coverage Medi-Cal services to young adults between ages 19 to 26, regardless of legal residency status, as long as they meet income and other eligibility requirements.

Full coverage Medi-Cal includes primary care, dental and vision services, as well as some specialty care.

Medi-Cal services have also expanded to cover new childhood screening programs to support healthy growth and development.

What is Retroactive Medi-Cal?

If you have unpaid medical or dental bills when you apply for Medi-Cal, you can ask for retroactive Medi-Cal.

Retroactive Medi-Cal may help pay medical or dental bills in any of the three months before the application date.

For example, if you applied for Medi-Cal in July, you may be able to get help with bills for medical or dental services you got in April, May, and June.

To get retroactive Medi-Cal you must:

  • Qualify for Medi-Cal in the month you got the medical services
  • Have received medical or dental services that Medi-Cal covers
  • Ask for it within one year of the month in which you received the covered services
  • You must contact your local county office to request retroactive Medi-Cal

Medi-Cal in San Diego County Summary

We hope this post on Medi-Cal in San Diego County was helpful.

Questions?

If you have further questions about Medi-Cal in San Diego 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:

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