Medicaid Application Instructions
There are three ways to apply for Med-Cal. No matter which way you choose you can use this web-site to get started. You can apply on line, in person or by mail.
E-benefits California (www.benefitscal.org) is an on-line website that allows you to apply for Medi-Cal on-line. Click here and follow the on-line instructions to get started.
Apply in Person or by Mail
It is recommended that you download the application first. Applications in various languages can be found by clicking here. You can also get an application directly from your counties office. Click here to see a comprehensive list of county offices. Once completed you can either mail it or bring it to your local county social services office.
Should you require more assistance or instructions please contact your nearest Local County Welfare Office (CWD). A list of local offices can be found here.
You can also apply for Medi-Cal by contacting your counties' eligibility department. These eligibility workers can also be found at health clinics and hospitals.
Here is step-by-step procedure to apply for Medi-Cal
- Call your CWD or visit CWD to get your application for Medi-Cal
- Fill the form once you get it from CWD
- Apply for retroactive benefits if you have any pending medical bills from the last three months
- Read about your rights and liabilities that will be created once you qualify to receive Medi-Cal benefits
- Provide documents for verification process
- Wait for approval - Typically, you will have to wait for up to 45 days
When you apply for Supplementary Security Income (SSI), you are automatically enrolled for Medi-Cal benefits. Typically, you will receive your Benefits Identification Card (BIC) immediately.
Beneficiaries of Medi-Cal will have to report any changes to their income, family composition, other health coverage, property etc within 10 days of such change.
You can apply for Medi-Cal even if you have health coverage other than Medi-Cal. In such cases, Medi-Cal will cover services your health plan doesn't cover.
Medi-Cal provides health benefits at low premium. You can view payment details in the Premium Payment Handbook available at this page for details.
You can find an official brochure here.
What is Retroactive Medi-Cal?
- You can receive medical expenses incurred three months before applying for the program
- You'll have to enter information about any pending medical bills from the last three months during application process
- Once accepted for benefits, you'll be checked for eligibility for receiving retroactive Medi-Cal cover
- If you qualify, a County representative will contact you and help you with the process to get retroactive Medi-Cal
Verification process for Medi-Cal
In order to qualify for Medi-Cal, applicants will have to provide certain documents for verification. Here is how you can verify each category using a wide range of allowed documents.
- Identity: In order to establish identity, applicants/beneficiaries will have to provide birth certificate, paycheck, driver license, U.S. passport, U.S. military ID, school records, State ID, or Indian Native Tribal documents.
- Social security Number: You can use either a social security card, Medicare card, or award letter to prove your Social Security number as you provided in the application form.
- Immigration: You can use INS documents to prove your immigration status.
- Residence: An applicant or beneficiary can provide proof of his or her residence by furnishing any of these documents, California driver's license, utility bill, rent receipt, mortgage receipt, driver license, check stub, any valid document showing your CA address.
- Income: Pay stub will be used to determine your earned income. However, the pay stub does not necessarily have to be from last 30 days. Other documents that can be used instead of pay stub to determine income are signed statement from employer, copy of tax returns, and bank statement. If an applicant cannot produce any of these documents or they are unable to determine earned income, applicant/beneficiary can sign a statement indicating monthly gross income. However, such statement will have to be signed under penalty of perjury. Self-employed persons can show a receipt of gross income or business records to establish their earned income.
- Unearned Income: In order to receive benefits under Medi-Cal, applicants will have to compare their income level to Medi-Cal Income Levels. You can find the complete chart here. Applicants/beneficiaries will have to show the most recent cost-of-living increase notice or produce an award letter. Applicant's current bank statement and copy of applicant's current benefit check can also prove unearned income. Applicants can also provide a statement signed by a person who has provided such additional income. Any of these documents will be sufficient to prove applicant's unearned income.
- Resources: In order to qualify to receive benefits under Medi-Cal, one must have assets under $2,000. The limit for couples is set at $3,000. Applicants can provide a bank statement with checking and savings accounts, life insurance policy, documents related to a trust, or mortgage documents to prove their resources. However, some resources such as your primary home, one vehicle, personal belongings, household goods, and prepaid burial plan are excluded from resources in order to calculate their value for the purpose of Medi-Cal.
Applicants/beneficiaries will have to sign Medical Care Residency Declaration MC 212 in order to receive medical benefits under Medi-Cal.
Other benefit programs related to Medi-Cal
- Supplemental Security Income (SSI): Those qualifying for SSI will automatically qualify for receiving full Medi-Cal benefits.
- Aged & Disabled federal Poverty Level (A&D FPL) Program: You can get Medi-Cal through A&D FPL program.
- Medi-Cal with a Share of Cost (SOC): If you are not eligible for Medi-Cal because of higher income, you can get Medi-Cal with a Share of Cost program.
- 250% California Working Disabled (CWD) Program: Applicants having higher income than required Medi-Cal level can qualify for 250% California Working Disabled (CWD) Program by paying a small monthly premium according to their income. Those who qualify for CWD will automatically qualify for Medi-Cal benefits.
In order to receive Medi-Cal Medicaid benefits, you'll have to meet the following general eligibility criteria:
- Be Residing in California
- 65 years and older
- 21 years and under
- Between 21 and 65 in some special circumstances
- Blind and/or disabled
- Pregnant women
- Receiving nursing home care
- Refugees and asylees in certain special circumstances
Citizenship: You don't have to be a U.S. citizen to receive benefits under Medi-Cal health program. However, some services may be restricted only to U.S. citizens. Typically, persons qualifying will receive pregnancy and emergency related medical services only. Availability of all the other services will depend on non-citizen status.
Your eligibility will be determined within 45 days after receiving your application. However, if you are applying for Medi-Cal on bases of disability, you should expect a 90-day period for eligibility to be determined by the competent authorities. However, pregnant women and minors requesting Consent services will receive their Medi-Cal identification card on the same day, in most cases. However, pregnant women will have to show physician's written statement to receive Medi-Cal benefits immediately. Pregnant women can also provide statement from a licensed midwife, certified nurse, or designated clinic personnel. Such statement should declare Estimated Date of Confinement (EDC) to qualify as a valid statement.