About us
We are a non-profit organization whose advocacy is to ensure consistent and maximized federal funding for California residents through the Medi-Cal program.
3 Main Medi-Cal Benefits You Need to Know
Caring for California residents for five decades, Medi-Cal is a health care program that provides free or affordable medical coverage for children, adults, and senior citizens who have low incomes and limited resources.
Essential health benefits
If you or a loved one is eligible for this health care program in California, you can enjoy a range of services in accordance with the Affordable Care Act that enjoins all Medi-Cal plans to provide the essential health benefits, including these general services:
- Laboratory services
- Outpatient services
- Hospitalization
- Emergency services
- Prescription drugs
- Care for pregnant woman and newborns – including baby products (ex: diapers, baby wipes or best shopping cart covers for babies)
- Vision and oral health care for children
- Behavioral treatment and other substance abuse disorder and mental health services
- Management of chronic diseases
- Occupational and physical therapy
Eye care benefits
For patients with full Medi-Cal benefits, vision benefits are included.
- Medi-Cal members can avail of a routine eye exam every other year, including eyeglass prescription testing.
- Coverage for frames and lenses are given only to nursing home patients and Medi-Cal members below 21 years old.
- Patients with impaired vision that cannot be corrected by standard eyeglasses (or surgery or contact lenses) can avail of low-vision testing. Those whose eye health problems hinder their ability to do their day-to-day tasks, especially the elderly with age-related macular degeneration, can enjoy this benefit as well.
- If an eye condition or health issue obstructs the use of glasses, Medi-Cal may cover contact lens testing.
- For patients who have lost their eyes to an injury or disease, they can avail of artificial eye services and materials.
Dental benefits
Available for children and adults, the dental benefits cover the following services:
- Cleanings
- Fillings
- Fluoride treatments
- X-rays and exams
- Full dentures
- Prefabricated crowns
- Root canals for the front teeth
- Tooth decay treatment, remineralize cavities and repair teeth naturally.
- Other needed dental services
For an appointment, contact a Med-Cal health care provider, which you can find by checking the online directory of the California Department of Health Care Services website.
Who can become a Medi-Cal Beneficiary? A Guide for California Residents
Are you wondering who can get Medi-Cal benefits? In general, Medi-Cal is a program that is intended for families with children, adults with low income, pregnant women, people with disabilities, elderly, former foster youth (up to 26 years old), and children in foster care.
But even though you have a house, a spouse, and a job, you may qualify for Medi-Cal services. Before you apply for one, you have to check first if you are eligible. Here are the categories identified as eligible patients under the Medi-Cal program:
Public assistance groups
- Seniors aged 65 and above and persons with disability who get Supplemental Security Income/State Supplementary Payment programs
- People who get California Work Opportunity and Responsibility to Kids
- California residents who are beneficiaries of other kinds of public assistance programs
Medically needy groups
- Seniors aged 65 and above and persons with disability
- California residents who meet the requirements for CalWORKS, e.g., children under 21 who are not supported by at least one parent because of death, absence, incapacity, and other reasons
Medically indigent groups
- Adults aged 21 to 65 who are in a nursing care facility
- Pregnant women without connection to a public assistance program
- Children under 21, including kids in foster care
- Children who qualify for the State-only Aid for Adoption Assistance Program
Special programs
- Children aged 1 to 18
- Children under age 21 who receive assistance from the Former Foster Child Program
- Pregnant women who cannot afford the cost of health care for themselves and their unborn child
- Refugees who are not eligible for the medically needy or medically indigent programs
- Non-U.S. citizens who are victims of human trafficking and other serious crimes
- People under the age of 21, unmarried, and living with parents can avail of confidential medical services relating to pregnancy, family planning, drug abuse, mental health, sexually transmitted diseases, and sexual assault.
- People who need parenteral hyperalimentation services or dialysis treatment
- Immigrants who satisfy all Medi-Cal eligibility requirements
For more information regarding your eligibility, you can contact your county eligibility worker.
How to Apply for Medi-Cal Program: A Guide for Health Care in California
Looking for information on Medi-Cal application procedures? You can apply personally in the social services office of your county or in a hospital or health clinic where Medi-Cal county eligibility workers are based.
Typically, here are the steps you need to take to apply for the Medi-Cal program:
1. Get a Medi-Cal application.
Contact or visit the social services office of your county to request for sending a Medi-Cal application to your home address. If you have an urgent need or medical emergency, you will have to fill out the form and bring it to the nearest social services office in your county. Inform the office that you are in need of immediate medical attention. Your Medi-Cal application will then be processed as soon as possible.
2. Complete the application form.
Make sure you answer all entries and check out the list of required documents for Medi-Cal applications.
3. Request for a Medi-Cal retroactive coverage.
This step is applicable to if you have unpaid medical bills within 3 months before you apply for Medi-Cal, and you need funding assistance for those bills. If you have paid the bills already, you can ask for reimbursement.
4. Send the completed application form and required documents.
You can do so personally or via mail to the county social services office.
5. Wait for your Medi-Cal application processing to be completed.
It may take a maximum of 45 days to process your application. It may take longer (90 days) if your Medi-Cal application is based on disability.
6. You will receive the results of your application via mail.
The letter will inform you whether your Medi-Cal application is approved or declined. However, if you have not received a feedback about your application after 45 days, contact the county social services office.
If you need more information regarding Medi-Cal applications, call the social services office in your county.
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