The People's Guide

35th Edition 2013-2014

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41 The People's Guide 2013-2014 Medi-Cal Medi-Cal The state and federal government fund Medi-Cal. There are many Medi-Cal pro- grams with different rules. Depending on which program you qualify for and how much money you make, Medi-Cal may pay for all your medical expenses or you might have to pay a share of the cost when you access health care services in a particular month. More children are now eligible for free Medi-Cal under the Targeted Low Income Program For Children (which replaces Healthy Families) . AM I ELEGIBLE? The following rules apply until January, 1, 2014, then they will change. 1. Groups of Eligibility You can get Medi-Cal if you: • Have low income and not many re- sources. • Are a California resident (which means that you intend to stay in California. This rule is not about immigration status) • Fit within one of the eligible groups of people If you are receiving CalWORKs, SSI, foster care, or certain refugee benefits, you get Medi-Cal automatically and do not need to apply separately. These groups can get Medi-Cal." • Pregnant women • Children under age 21 • Adults 65 or over • People of any age who are disabled or blind by SSI guidelines (whether or not you are getting SSI) (see page 21 "SSI") • Certain families who are needy by Cal- WORKs guidelines, whether or not you are receiving CalWORKs (see page 4 "CalWORKs.) Briefly, one parent must be absent, deceased, medically docu- mented as disabled or unable to work, unemployed, or under-employed. "Un- employed" means that the parent who has earned the most in the past two years is working less than 100 hours a month. "Underemployed" means that the family's earned income is below the federal poverty level. • Caretaker relative of a minor child under 21 • Refugees (as defined by the federal government) • People living in a long term care facility • People infected with tuberculosis • (unless undocumented) • a man or woman diagnosed with breast cancer or a woman diagnosed with cervical cancer Besides fitting into one of the above categories, you must also meet certain income and resource limits, described on pages 39/40. These rules will change in 2014. In 2014 all adults who are U.S. citizens or legal permanent residents for at least 5 years, and have income below 133% of the Federal Poverty Level (see chart on page 40) will qualify for a free Medi-Cal program. Adults with higher income may qualify for health coverage under Covered California Visit: 2. Immigration status Most legal immigrants can get regular (also called full-scope) Medi-Cal to cover all their medically necessary health needs. Victims of domestic violence or those in the process of adjusting their legal status can also get MediCal (i.e., they are applying for Legal Permanent Residency).(See page 62 Guide for Non-Citizens) If you are undocumented, and a California resident, and meet other Medi-Cal require- ments, you can apply for a restricted Medi- Cal card, even if you're undocumented. Restricted Medi-Cal means that you can get Medi-Cal to pay for emergency services, pregnancy-related care, family planning, kidney dialysis, and long term care services. Medi-Cal is California's program to pay for medical care for certain low-income people, such families, children, the elderly, and people with disabilities. As of Janu- ary, 2014, many adults who could not get Medi-Cal under the old rules will be able to get Medi-Cal under the new rules of The Affordable Care Act (Obama Care). HOW DO I APPLY? 1. Get an application form • You can get an application form mailed to you by calling the DPSS toll-free number at • (877) 597-4777. • Or you can get one at a DPSS Office. (See page 70 "Welfare Offices." ) • Or you can get one at many hospitals and clinics, whether they are private or county-run. • A few schools in Los Angeles County can have children apply for Medi-Cal at the same time they apply for the Free and Reduced-Cost Lunch program, using the same application. • See page 48 for a complete list of First 5-funded agencies who have applications and assist people with the application process. 2. Apply online Using Health-e-App (for Medi-Cal and Healthy Families for children) or Your Benefits Now, or Covered California start- ing in October. Health-e-App is a Web-based application for enrolling children under 19 into Medi- Cal and in the past, into Healthy Families. To Access Health-e-App,visit:https://www. Your Benefits Now! is a website for Los Angeles County Residents to apply for and to view their benefits online. Visit: 3.Children Under Age 19 If you are applying for Medi-Cal for your children under age 19 you should use the "Joint Medi-Cal and Healthy Families mail-in application" (MC221). You can get one mailed to you by calling (877) 597-4777 or (800) 880-5305 (this number may have more staff speaking languages other than Spanish or English). If your application is approved your child will receive no-cost Medi-Cal for at least 2 months while the county reviews your application for Medi-Cal. This application has a place to check if adults in the household want Medi-Cal, too. The Medi-Cal worker should call and follow up to help the adult apply. Accelerated Enrollment If DPSS determines that your child is eli- gible , the no-cost Medi-Cal will continue (beyond the temporary period) until your MEDI-CAL INFORMATION: (877)597-4777

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