What to Expect After Applying for California Medicaid

The state’s Medicaid program, Medi-Cal, is designed to help people with low income and resources get medical care. It also provides health insurance to children under age 21 and pregnant women. Most people qualify for Medi-Cal because they are below the federal poverty level (FPL).

How Long Will the Process Take?

Once you submit your application, you will receive a Notification of Likely Eligibility (NOA). You will also get a Benefits Identification Card (BIC). This card lets you know you’ve been approved for Medi-Cal.

You will then receive a packet by mail with health plan options to choose from. You will have 30 days to pick a plan. The state will choose one for you if you don’t choose within that time.

So what do we need to know about the California Medicaid requirements? Remember, if you choose a Medi-Cal plan, your doctor or doctor’s group must be in the plan. You can find a list of Medi-Cal doctors.

Contact your county human services office for assistance if you have any questions. They can help you complete your application and explain your rights.

Many people are eligible for California Medicaid and other state programs because they have low incomes, but other factors can also make you eligible. For example, you might be pregnant or have a disability.

You can apply for California Medicaid online, by phone, or in person. It’s important to provide the required information so your application can be processed quickly. The information you provide will be kept secure according to federal and state law.

What Happens If I Don’t Qualify?

Don’t panic if you receive a Notice of Action letter from your county stating that you no longer qualify for California Medicaid, don’t panic. You can still find a health plan through Covered California. You can also get financial help to lower your premiums or reduce out-of-pocket costs.

People who no longer qualify for Medi-Cal may be eligible for federal subsidies and various coverage options on the Covered California marketplace. These may include private plans, cost-sharing reductions, and tax credits.

You can find your income eligibility information on the Covered California website. The system compares your income and household size to the federal poverty level.

Once you have the income information, you can contact your County Eligibility Worker to ask if you are eligible for Medi-Cal. They can give you an estimate of your eligibility and assist with the application process.

Your county can verify your eligibility and send you a Notification of Likely Eligibility (NOLE) letter by mail. You should have this letter in your mailbox within a few days.

After applying for Medi-Cal, it is important to maintain accurate records of your income and family members’ income and assets. If you fail to provide the correct information or change your income, your eligibility will be reassessed.

You may have to pay back the money you received in subsidies if you underestimated your income or experienced a job loss. You can also have to pay back the subsidy if you are found to have earned less than your earnings were reported on your taxes.

What If I Don’t Get Approved?

If you don’t get approved for California Medicaid, options are available to help you find a health plan. These options include Medi-Cal and Covered California, the state’s health insurance marketplace.

You can apply for a plan through Covered California any time of year. You can also receive financial help to lower your premiums or out-of-pocket costs. However, your eligibility for financial help will vary based on your annual income.

Another option is to sign up for a minimum coverage plan through Covered California (also known as a catastrophic plan). These plans include three doctor visits or urgent care appointments and free preventive services. If you need more than this, you can get additional coverage.

A final option is to enroll in a private health plan. If you do, you can use Medi-Cal to pay for allowable costs that your private plan doesn’t cover.

It’s important to remember that Medi-Cal is a joint federal/state program. The California Department of Health Care Services will determine your eligibility and enroll you in the best program.

You can also get information about your options for insurance through the California Health Benefit Exchange. You can use this website to shop for a plan, receive enrollment assistance, and get matched with financial help if you are eligible.

You may be surprised at how affordable and easy it is to get covered if uninsured. But many people don’t take advantage of these options because they worry about the cost or think they won’t qualify for coverage.

What If I Get Approved?

You will receive a Benefits Identification Card (BIC) in the mail if you get approved. This is your key to accessing your Medi-Cal benefits. You can use it to see a doctor or go to the pharmacy.

Many people apply for Medi-Cal because they can’t afford health insurance. If you have insurance through a private plan, you should report that when you apply for Medi-Cal. The program may cover some allowable costs that aren’t covered by your primary insurance, such as prescriptions and dental care.

You can also apply for California Medicaid if you are older than 65 or have certain disabilities and meet income guidelines. These programs are funded by federal and state taxes and provide health care coverage to low-income people.

In California, there are 1.6 million people who are dually eligible for Medicare and Medi-Cal. This means they are eligible for both programs, and their Medi-Cal and Medicare coverage works together to coordinate and provide care.