Disclaimer: These materials are based on the law at the time we write them. We try to update our materials; however, laws are regularly changing. If you want to make sure the law has not changed, contact us or another legal source.
Medi-Cal Programs to Help You Stay in Your Own Home or Leave a Nursing Home
This publication provides information about California programs that help people with disabilities, including children and seniors, who receive Medi-Cal stay in their home or return home from long-term care facilities like hospitals, nursing homes, and other medical facilities.
Dental Services through Medi-Cal
Medi-Cal provides dental services for adults and children. Comprehensive dental services are a mandatory benefit for Medi-Cal beneficiaries under age 21. For adults 21 and over, California has the option of providing Medi-Cal coverage for dental services.
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.
Medi-Cal Specialty Mental Health Services Covered by County Mental Health Plans – Adults Ages 21 and Older
You can get mental health services through Medi-Cal. You can get them through fee-for-service or managed care plans. In addition, you can get Medi-Cal mental health services through county mental health plans. This pub tells you about county mental health plan services.
Disabled Adult Child (DAC) Medi-Cal Program Benefits
What is the Disabled Adult Child (DAC) Medi-Cal Program? Am I eligible for the DAC Medi-Cal Program? Find the answers to these DAC questions and more in this publication.
Important Changes Coming to Medi-Cal in December 2020 for Many Age 65 or Older and People With Disabilities
This publication identifies changes and updates that advocates need to know about the aged, blind, and disabled FPL Medi-Cal Exapansion starting December of 2020.
Hospital Discharge Rights for Medi-Cal and Medicare Recipients
This pub tells you about your rights when discharged from a hospital and you have Medi-Cal or Medicare. It tells you what to do if you are not ready to leave the hospital. It tells you about services you can get once home. It tells you what to do if you are homeless. It tells you how to complain about the hospital and where to get help.
Getting Communication Supports through Medi-Cal
Did you know that if you get Medi-Cal and your disability makes it hard for you to communicate, Medi-Cal might pay for communication supports that you need?
Medi-Cal: Where to Find Laws, Regulations, and Other Helpful, Free Information on the Internet
Lump Sum Payments and Medi-Cal Eligibility
Many people have questions about how a nonrecurring lump sum (one-time-only) payment will affect their Medi-Cal eligibility. This publication describes how lump sum payments affect eligibility for certain Medi-Cal programs for seniors and persons with disabilities. It explains what happens to your Medi-Cal when you receive a one-time or lump-sum payment, and when and whether an unspent lump-sum payment counts as a resource in the following month.
How the Aids Medi-Cal Waiver can Help you get the Care you Need at Home Instead of in a Medical Facility
This publication tells you about the HIV/AIDS Medi-Cal Waiver Program. The program has case management services. It has direct care services for people living with HIV/AIDS. These services are instead of living in a nursing home or hospital. You can use it to help you stay at home. You can use it to help you go home from a facility. The publication tells you who is eligible. It tells you about the services you can get.
Fact Sheet: How Medicaid/Medi-Cal Affects Regional Center Consumers
The Lanterman Act is the California law that guarantees more than 300,000 people with developmental disabilities the right to services and supports they need to live a more independent and productive life...
What is Adult Expansion / MAGI Medi-Cal?
The Affordable Care Act (ACA) (also known as Obamacare) has increased the number of people who can get Medicaid (Medi-Cal in California). “Adult Expansion Medi-Cal” or Medi-Cal for “childless adults” is part of what is now being called “MAGI” Medi-Cal under the ACA. “MAGI” Medi-Cal means any Medi-Cal program that uses MAGI (modified adjusted gross income) to determine financial eligibility for Medi-Cal.
Worksheets for Determining Eligibility Under the Aged & Disabled Federal Poverty Level (A&D FPL) Medi-Cal Program
This publication and the accompanying worksheets may be used to determine if an individual, couple or an individual in a family may qualify for the ABD FPL Medi-Cal program. The ABD FPL program is a no-share-of-cost, full-scope Medi-Cal Program for people who are over the age of 65, or who have a disability.
Using Your Medi-Cal Share of Cost if You are a Nursing Facility Resident
If the Medi-Cal program is paying or your nursing facility care and if you also have income – such as from Social Security benefits – you will have a Medi-Cal share of cost equal to all of your income above $35 a month. “Nursing facility” includes a subacute facility and...
Applying for Medi-Cal & Other Insurance Affordability Programs
Medi-Cal is a health insurance program for people with limited income. The Affordable Care Act (ACA) made some helpful changes to Medi-Cal to make more people eligible. The ACA also created health benefit marketplaces (exchanges) to help people get health care coverage if they do not have it already.
Coordinated Care Initiative (CCI): Basics for Consumers
The Coordinated Care Initiative (CCI) is a program that changed the way certain people in California get their health care and their long-term services and supports (LTSS).
Fact Sheet: How does Medicaid/Medi-Cal Affect Veterans
Medicaid is a critically important source of health care coverage for veterans with disabilities. Nationwide, approximately 1.75 million veterans need Medicaid. Many of them have traumatic brain injuries, spinal cord injuries, and other disabilities, and are at grave risk if Medicaid is cut.
Fact Sheet: What is Medicaid/Medi-Cal?
The federal Medicaid program provides health care to low-income people, including seniors, people with disabilities, and children. Medicaid is funded through a combination of state and federal dollars.
Medi-Cal Exemption Requests (MERs)
Since 2011, California has been in the process of moving seniors and people with disabilities (SPDs) with Medi-Cal only and those eligible for both Medicare and Medi-Cal (dual eligible) into Medi-Cal managed care plans (Medi-Cal MCP) instead of traditional, regular, or fee-for-service Medi-Cal.
Medi-Cal Managed Care: Appeals and Grievances
Medi-Cal Managed Care: “Continuity of Care”
This publication tells you about Medi-Cal “continuity of care.” If you have to enroll in a Medi-Cal managed care plan, you may be able to see your regular Medi-Cal health care provider. This is what “continuity of care” means. The publication tells you what to do if you cannot get it.
Medi-Cal Managed Care: An Independent Medical Review (IMR) Can Change a Plan’s No to Yes
Most Californians who get Medi-Cal are in managed care through a Medi-Cal health plan. Health plans are also called managed care organizations or health maintenance organizations.
Medi-Cal managed Care - Out of Network Services
Medi-Cal managed care health plans have networks of providers. Providers are doctors, pharmacies, clinics, labs, and hospitals. Most of the time, you must use the plan providers. There are times when you can get health care from providers who are not plan providers. They are “out-of-network” providers. This pub tells you when you can use such a provider. If Medi-Cal tells you that you cannot go “out-of- network, the pub tells you what to do.
Medi-Cal Managed Care Plans And Mental Health Services
You can get some mental health services from fee-for-service Medi-Cal or Medi-Cal managed care plans. You can only get certain services from county Mental Health Plans. This publication tells you what services you have to get from the county and about mental health services available from Medi-Cal managed care plans. Managed care is a way to provide and pay for health care. You receive most of your health care from a managed care plan. A managed care plan is an organized network of health care providers that focuses on primary and preventive care. Hospitals, physicians and other health care providers are members of the network. This publication tells you what services you can get. It tells you what to do if you do not agree with the health plan.
Medi-Cal Managed Care Time and Distance Standards for Providers
Medi-Cal managed care plans have to have providers within a certain time and distance from the patients’ home or “time and distance” standards. Managed care is a way to provide and pay for health care. You receive most of your health care from a managed care plan. A managed care plan is an organized network of health care providers that focuses on primary and preventive care. Hospitals, physicians and other health care providers are members of the network. This publication tells you about the “time and distance” standards for providers. It tells you what to do if your plan does not follow its “time and distance” standards.
Rural Medi-Cal Managed Care: Access to Care in Rural Counties
You have the right to get timely access to the health providers you need, including primary care physicians, specialists, and hospital care. Sometimes we hear from clients who are having trouble finding providers. This fact sheet gives you information and tips on what to do if you live in a rural area and you have Medi-Cal managed care.
Timely Access to Medical Care
California law says that managed care plans must make sure that you receive access to healthcare in a timely manner.
Transportation Services for Medi-Cal Recipients
This fact sheet explains how to obtain transportation to your medical appointments from your Medi-Cal Managed Care Plan (MCP). The end of this publication discusses how to obtain transportation services if you have Fee-For-Service (FFS) Medi-Cal.