Medi-Cal Eligibility Requirements in California

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Medi-Cal is a public health insurance program that provides needed health care services to people with low incomes, particularly the elderly, the disabled, families with children and people with specific diseases, like HIV/AIDS, cancer and tuberculosis. Medi-Cal, which is California's Medicaid program, is financed equally by the state and federal government and can be applied for through and is administered by local county health offices throughout the state.

Age

  • Anyone 65 or older is automatically eligible to enroll in Medi-Cal, as is anyone who is under the age of 21. People between those ages are eligible if they are the parent or a caretaker relative of a child under 21, but only if one or more of the child's parents are deceased or doesn't live with the child; or if the child's parent is incapacitated; or if the child's parent is unemployed or under-employed.

Program Enrollment

  • People who are already enrolled in certain assistance programs are automatically eligible to enroll in Medi-Cal. The five programs are Supplemental Security Income/State Supplementary Payment, or SSI/SSP, which is a federally-funded program that provides income support to the elderly, blind and disabled; CalWorks, which provides temporary financial assistance and employment services to poor families with minor children; Refugee Assistance, which aids refugees from other countries who are resettling in California; the state's foster care or adoption assistance program; and In-Home Supportive Services, or IHSS, a program that helps the blind, disabled and elderly with payments for expenses like housecleaning, laundry, grocery shopping, accompaniment to medical appointments and supervision for the mentally impaired.

Women

  • Females who are pregnant are automatically eligible for Medi-Cal, as are women who are participating in the state's Breast and Cervical Cancer Treatment Program, which is open only to low-income women who are California residents.

Waivers

  • Medi-Cal participation waivers can be granted to individuals who otherwise wouldn't be eligible to enroll in Medi-Cal. Such waivers must be authorized by the federal government after a request by the state's Department of Health Care Services. Waiver services are geared toward specific populations and targeted groups based on need, and the review process for Medi-Cal eligibility and waiver eligibility can take place at the same time. County health offices have full details on waiver eligibility in particular areas.

References

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