Basic Medicaid Coverage in California

The Medicaid program was established by the federal government to provide health care coverage for low-income families and certain special populations. Medicaid is administered by each state's health or social services department. In California, no-cost health insurance is available through the Medi-Cal program. The program provides a number of health care benefits for individuals who qualify.

Medi-Cal Benefits

• The Medi-Cal program provides comprehensive, no-cost health coverage for qualifying individuals. This includes coverage for regular check-ups, emergency care, inpatient and outpatient services, prescription drugs and long-term care. The program also covers drug and alcohol treatment, mental health care, vision services, occupational therapy, physical therapy and dental care for children. Medi-Cal also pays the cost of certain medical equipment, including wheelchairs, hearing aids and prosthetics. Medi-Cal does not pay for adult dental services, hearing exams, chiropractic services, podiatry services, speech therapy, psychological counseling or acupuncture.

Eligibility Requirements

• You automatically qualify for Medi-Cal if you currently receive Social Security benefits or Supplemental Security Income, Aid for Families with Dependent Children (AFDC) benefits, refugee assistance, foster care or adoption assistance payments or in-home supportive services. You also qualify if you are under 21 or over 65, if you are blind or disabled, if you're pregnant or nursing or have been screened for breast or cervical cancer. If you do not fall into one of these categories, your eligibility is assessed based on your income and family size.

Applying for Medicaid

• Applications for Medicaid are available at the social services office in your county. If you are unable to pick up an application in person, you may call the social services department and have one mailed to you. When you complete the application, you must provide the names, ages and Social Security numbers of everyone in your house. You must also provide information regarding your assets and all sources of income. The completed application must be submitted to a social services caseworker, who may ask you to provide additional information or documentation. Applications typically take up to 45 days to process.

Considerations

• If you obtain Medicaid benefits by intentionally providing false or incorrect information on your application, this is considered fraud. In addition to having to repay any benefits you received, you may also be fined or imprisoned, depending on the extent of the fraud. If you are ineligible for Medicaid benefits and your children lack health insurance, you may apply for benefits under the Healthy Families program. This program provides low-cost health insurance to children and teens, including vision and dental care. Monthly premiums and co-pays are based on your income.