Medi-Cal Renewals and the COVID-19 Public Health Emergency
Medi-Cal Renewals and the COVID-19 Public Health Emergency
In January 2020, the federal government declared a public health emergency (PHE) in response to the COVID-19 pandemic. During the PHE, people could keep their Medi-Cal benefits despite an increase in income or other changes that might make them otherwise ineligible. However, the Consolidated Appropriations Act of 2023 changed that rule.
What is the COVID-19 public health emergency and how does it affect my Medi-Cal benefits?
In January 2020, the federal government declared a public health emergency (PHE) in response to the COVID-19 pandemic.1 During the PHE, people could keep their Medi-Cal benefits despite an increase in income or other changes that might make them otherwise ineligible. However, the Consolidated Appropriations Act of 2023 changed that rule. 2 This means that, beginning April 1, 2023, county Medi-Cal departments will start reviewing whether people still qualify for Medi-Cal.3 Losing Medi-Cal coverage can also affect other Medi-Cal connected benefits, like In-Home Supportive Services. It is important to be prepared.
Am I still eligible for Medi-Cal?
It depends. First, you should contact your county Medi-Cal office online or by phone, email, fax, or in person and make sure they have your updated mailing address, phone number, and email address. You can find your local county Medi-Cal office here: https://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx. You can also access your Medi-Cal case and report changes online at mybenefitscalwin.org*4 or benefitscal.com.5
It is important that your county Medi-Cal office has your current contact information because they will send you information in the mail regarding your eligibility and whether you need to complete your annual renewal forms. Most people will receive a renewal packet approximately 6 weeks before your regular Medi-Cal renewal month (some people will be renewed automatically, like if you receive Supplemental Security Income, zero income, or other eligibility factors that the county Medi-Cal office can verify electronically).6 If you don’t remember your renewal month, you can contact your county Medi-Cal office. And you should watch your mail closely for a yellow envelope that will have your renewal form. You should complete and send back any renewal information requested to see if you qualify for Medi-Cal or other no-cost or low-cost health care options. You can send back your renewal information by mail, in person, phone, or online (see above for how to contact your county Medi-Cal office). Check your mail often – that’s how you'll find out if you need to give the county information to keep your Medi-Cal.
What if I’m no longer eligible for Medi-Cal?
If the county informs you that you no longer qualify for Medi-Cal, you have a couple options:
- You can appeal. If you think the county is wrong and that you’re still eligible for Medi-Cal, you can ask for a Medi-Cal Fair Hearing. You must file your appeal within 90 days7 of receiving the Notice of Action (NOA). If you want your Medi-Cal benefits to continue while your appeal is pending, you must file your appeal within 10 days of receiving the NOA or before the negative action takes effect. For more information on how to appeal, visit DHCS’ website at: https://www.dhcs.ca.gov/services/medi-cal/Pages/Medi-CalFairHearing.aspx.
- You should ask your county case worker if you are eligible for any other type of Medi-Cal program.8
- If you are no longer eligible for Medi-Cal, you may be eligible for low-cost coverage through Covered California. Your county Medi-Cal office should send your information directly to Covered California and Covered California will contact you. If you haven’t heard from Covered California, you can contact them at: (800) 300-1506 or www.coveredca.com/special-enrollment/. Losing Medi-Cal coverage is a qualifying life event that will allow you to enroll in Covered California.
If you need additional assistance, you can contact Disability Rights California toll free at (800) 776-5746 or TTY: (800) 719-5798. You can also visit our website at www.disabilityrightsca.org.
What if I also have Medicare?
If you also have Medicare and you lose your Medi-Cal benefits, you may encounter issues with your Medicare Advantage plans (also called Dual Eligible Special Needs Plans or D-SNPs). To discuss any issues, contact the California Health Insurance Counseling and Advocacy Program (HICAP) at (800) 434-0222 or https:/www.aging.ca.gov/hicap/. You should also contact HICAP if think you are eligible for Medicare and did not enroll during the PHE.
Disclaimer: This publication is legal information only and is not legal advice about your individual situation. It is current as of the date posted. We try to update our materials regularly. However, laws are regularly changing. If you want to make sure the law has not changed, contact DRC or another legal office.
- 1. https://aspr.hhs.gov/legal/PHE/Pages/covid19-11Jan23.aspx; the federal PHE will expire on May 11, 2023 (https://whitehouse.gov/wp-content/uploads/2023/01/SAP-H.R.-382-H.J.-Res.-7.pdf).
- 2. https://www.congress.gov/bill/117th-congress/house-bill/2617.
- 3. https://www.dhcs.ca.gov/Documents/PHE-UOP/Medi-Cal-COVID-19-PHE-Unwinding-Plan.pdf.
- 4. If you live in the following counties: Alameda, Contra Costa, Fresno, Orange, Placer, Sacramento, San Diego, San Francisco, San Luis Obispo, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Solano, Sonoma, Tulare, Ventura, or Yolo. *Please note that from October 2022 to October 2023, this website is being phased out for each county listed and will change to: benefitscal.com (https://wclp.org/benefitscal-a-new-way-to-get-calfresh-medi-cal-cash-benefits/).
- 5. If you live in the following counties: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Imperial, Inyo, Kern, Kings, Lake, Lassen, Los Angeles, Madera, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Plumas, Riverside, San Benito, San Bernardino, San Joaquin, Shasta, Sierra, Siskiyou, Stanislaus, Sutter, Tehama, Trinity, Tuolumne, or Yuba.
- 6. https://www.dhcs.ca.gov/Documents/PHE-UOP/Medi-Cal-COVID-19-PHE-Unwinding-Plan.pdf, pages 18-19, 22.
- 7. As of the date of this publication, DHCS has asked the federal government to extend this appeal deadline by an extra 120 days under section 1902(e)(14)(A) of the Social Security Act and is awaiting a response. While the PHE is in effect (until May 11, 2023) recipients have an extra 120 days to file an appeal. This means you have 210 days total. If you miss your appeal deadline, you may ask for “good cause” for late filing.
- 8. www.dhcs.ca.gov/services/medi-cal/Pages/DoYouQualifyForMedi-Cal.aspx.