How to Apply for Medi Cal

How to Apply for Medi-Cal (California Medicaid)

Eligibility Requirements

Medi-Cal provides free or low-cost health coverage to California residents who meet certain income and category requirements. Income: Eligibility is primarily based on household income relative to the Federal Poverty Level (FPL)​. For example, a single adult with annual income up to about $20,783 (approximately 138% of FPL) may qualify, with higher cutoffs for larger families (around $28,200 for a two-person household). Higher thresholds for certain groups: Pregnant women, children, and disabled individuals are allowed higher income limits and are encouraged to apply even if their earnings are above the standard cutoff. In fact, children and youth up to 21, pregnant individuals, and people with disabilities often qualify at income levels above 138% FPL. Categorical eligibility: You can also qualify based on life circumstances. Medi-Cal covers adults 19–64 who meet income criteria, and also those who are 65 or older, blind or disabled, children under 21, pregnant, or residing in a nursing or care home. Being in certain programs automatically makes you eligible as well – for instance, if you receive SSI/SSP (Supplemental Security Income/State Supplementary Payment), CalWORKs (cash aid), CalFresh (food assistance), or are in foster care or adoption assistance, you are automatically eligible for Medi-Cal coverage. There is no asset/resource test for most applicants (income-based Medi-Cal), but seniors and disabled applicants may have resource limits (e.g. savings) – these rules have been largely eased in recent years, so don’t assume you’re ineligible without checking. Finally, you must be a California resident to get Medi-Cal, but you do not need to provide a separate proof of residency document; you simply give the address where you live/receive mail and attest you reside in state. U.S. citizens and many lawful immigrants qualify for full Medi-Cal; undocumented individuals may qualify for limited-scope Medi-Cal (emergency or pregnancy-related services), though California has expanded full coverage to all income-eligible persons up to age 26 and 50+ regardless of immigration status. In short, if you have low or moderate income or meet any of the criteria above, you should consider applying for Medi-Cal.

Required Documentation

When applying, be prepared to provide information and paperwork to verify your eligibility. Medi-Cal will attempt to verify things electronically, but you may be asked for documents if needed​. Common documents include:

• Proof of Identity and Social Security Number: A copy of a driver’s license or other photo ID, and your Social Security number (or card)​. Non-citizens should provide immigration documents or ID numbers, if available​. (Immigration status is only used to determine what services you qualify for, not to disqualify you outright – many immigrants still get Medi-Cal.)
• Proof of Income: Recent pay stubs or a letter from your employer showing your earnings and hours​. You might also use a recent tax return (Form 1040 or Schedule C if self-employed) to show annual income​. If you receive benefits like Social Security, veterans’, unemployment, or disability payments, bring the award letters or benefit stubs​. (If you have no income or only cash income, you can “self-attest” and the county can guide you on how to declare that​.)
• Household Information: You will need to report who is in your household, such as family members and dependents. If someone files taxes, you may be asked about tax filing status and dependents (because Medi-Cal uses tax household rules for income-based cases)​. Having Social Security Numbers for each applicant helps speed up verification​ (those not applying or not eligible for an SSN don’t have to provide one).
• Proof of Expenses/Deductions (if applicable): If you pay for certain things that can affect eligibility (like child care, child support, alimony, or health insurance premiums out-of-pocket), you might need to show receipts or statements for those costs. These can sometimes increase your eligibility by lowering countable income.
• Proof of Assets (if 65+ or disabled): For applicants qualifying under age or disability rules (which have an asset limit), you may need to provide information on property or resources​. This could include bank account statements, vehicle registrations, life insurance policies, etc., but only if you’re applying in a category that still has asset tests (most people under the expansion Medi-Cal don’t need to list assets).

Important: The county will let you know exactly what documents are required. If you lack a particular document, they will work with you on alternatives. Don’t delay applying just because you’re missing a piece of paperwork – you can submit the application first and provide additional proof later if asked.

Ways to Apply (Online, In Person, Mail, or Phone)

California offers multiple convenient ways to apply for Medi-Cal – there’s “no wrong door,” so use whatever method works best for you​

dhcs.ca.gov

. All application methods use the Single Streamlined Application, meaning you’ll be evaluated for Medi-Cal and other programs (like Covered California plans) as appropriate. Here are the main options to submit your application:

• Online: You can apply online at the Covered California website (CoveredCA.com)​. Covered California is the state’s health insurance marketplace; it forwards Medi-Cal applications directly and securely to your county social services office. The online application will ask the necessary questions for Medi-Cal and let you know if you’re likely eligible. (In many counties, you can also apply through the local online portal like MyBenefitsCalWIN or BenefitsCal.com, but those ultimately send your info to the county as well. CoveredCA is the primary statewide online channel.)
• In Person: You may apply in person at your local county social services or human services office​. Every county in California has an office that handles Medi-Cal applications. An eligibility worker can sit down with you, provide the paper application, and help you fill it out if needed. This is a good option if you want personal assistance or have questions. You can find your county Medi-Cal office via the DHCS website or by calling ahead​.
• By Mail: You can fill out a paper Single Streamlined Application (sometimes called MC 210 or “SAWS 2 Plus” form) and mail it in​. You can obtain this form by downloading it (available in multiple languages)​ or picking it up from a county office or clinic. Once completed and signed, mail the application (and copies of any required documents) to your local county social services agency​. The county’s mailing address for Medi-Cal applications can be found on the county website or by calling them. (Some counties also accept applications by fax or email – check with your local office for those options – but mail is the standard statewide method.)
• By Phone: You may also apply over the phone by calling your county’s Medi-Cal office​. During business hours, a county eligibility worker can take your application information by phone and mail you a summary to review/sign. If you’re not sure how to reach your county office, you can call Covered California at 1-800-300-1506, and they can either assist with the application or direct you to your county​. Phone applications are useful if you cannot get online or travel, and you can still submit any required documents by mail or electronically afterwards.

No matter which method you choose, the information required is the same. Applying is free, and if you’re unsure about any question, you can get help (see the Assistance section below). Tip: If you apply online or by phone and complete your application, do not also mail a paper application – duplicate applications can cause delays​. The systems all route to the same place (your county office), so one application is enough.

Application Process and Timeline

Once you submit your application, it goes through a review process at the county level. Here are the typical steps, from submission to enrollment:

1. Submit Your Application: Complete all required sections of the application and submit it via your chosen method (online, mail, phone, or in person). The county will receive your application and begin processing it​. (If you applied through Covered California, it first checks if you appear eligible for Medi-Cal, then transfers your case to the county.)
2. Initial Eligibility Review: The county social services agency will evaluate your information. In many cases, you will receive a “Notification of Likely Eligibility” by mail soon after applying​. This is a preliminary notice indicating whether you are likely eligible for Medi-Cal or if you might be referred to other programs. This notice is not final approval, but a good sign that things are moving.
3. Follow-Up for Verification: If any additional information or verification is needed, a county eligibility worker may reach out to you by mail or phone​. For example, if something couldn’t be verified electronically (such as unclear income data or citizenship status), they will send you a written request for specific documents or details. Be sure to respond to any such requests as soon as possible. You can submit extra documents in person, by mail, or sometimes via an online portal or email – the notice will include instructions. This step is basically to confirm your eligibility with proper documentation.
4. Final Determination: After reviewing all required information, the county will make a final eligibility decision. You will then receive a formal Notice of Action letter informing you whether you have been approved for Medi-Cal (or denied)​. If approved, the notice will list who in your household is eligible and for what type of Medi-Cal coverage. If denied, the notice will explain the reason and provide information on how to appeal or get other coverage (e.g. through Covered California).
5. Receive Your Benefits Card: Upon approval, each person approved for Medi-Cal will be issued a Medi-Cal Benefits Identification Card (BIC), which is the plastic ID card used when you go to the doctor or pharmacy​. This card is mailed to you, typically within a couple of weeks after approval. Using Your Coverage: Keep this card safe – you will need to show it to healthcare providers to prove you have Medi-Cal. Coverage usually begins retroactively to the 1st day of the month in which you applied (once approved)​, so any medical expenses from that date forward should be covered.

Example of a Medi-Cal Benefits Identification Card (BIC). New enrollees will receive a card like this by mail after approval, which they can use to access services​.

Choosing a Health Plan: In most California counties, Medi-Cal is provided through managed care plans. Shortly after approval, you will be asked to choose a Medi-Cal managed care plan available in your county (such as Anthem, Blue Cross, Kaiser, Health Net, etc., depending on where you live)​. You’ll get information about the plans and a deadline (usually 30 days) to choose one. If you don’t choose by the deadline, one will be assigned to you automatically. (A few counties still offer an option to remain in “fee-for-service” Medi-Cal, but most require plan enrollment.) You will receive a separate welcome packet and insurance card from the health plan you enroll in, but you should always keep your Medi-Cal BIC as well.

How long does approval take? The Medi-Cal application process can take some time, so plan accordingly. Typically, it takes up to 45 days from the date the county receives your complete application to process it and send you a final decision​. Many applications are processed faster, but 45 days is the standard allowable timeframe. If you are applying on the basis of a disability, it could take up to 90 days because of the extra steps to verify disability status. You should receive either your approval notice or a request for more information within this window. If 45 days pass and you haven’t heard anything, it’s a good idea to follow up with the county (see “Checking Your Application Status” below).

Interim coverage if you have urgent needs: If you need medical care while your application is pending, there are options to get temporary coverage. Hospitals and certain clinics can provide Presumptive Eligibility Medi-Cal (immediate, short-term coverage) if you appear eligible, especially for pregnant individuals and children​. Also, county offices can issue a temporary paper Medi-Cal card or number once you’re found likely eligible, so you can visit a doctor or pharmacy before your BIC arrives. Don’t hesitate to mention any urgent medical needs (such as pregnancy, ongoing prescriptions, or a scheduled surgery) to the county worker – they can expedite your case or provide guidance to ensure you get care. And remember, once approved, Medi-Cal will cover retroactively to the application month, so you can potentially get reimbursed for covered services incurred during the waiting period.

Deadlines and Important Considerations

• No Open Enrollment Period: Unlike private insurance, Medi-Cal has no specific enrollment period or deadline – you can apply at any time year-round​. If you need coverage, you do not have to wait for an open enrollment season. However, if you’re also considering a Covered California health plan, keep in mind those plans do have an open enrollment window each year (and special enrollment periods for qualifying life events). Medi-Cal, though, is available whenever you qualify.
• Processing Time and Follow-Up: As noted, most applications are processed within 45 days (90 days if disability-related)​. During this time, be sure to check your mail and messages frequently in case the county requests additional information. Missing a deadline to return requested documents can delay your application or even result in a denial. If you receive a request and don’t understand it, contact the county immediately for clarification or assistance. It’s important to respond before the due date on any correspondence.
• Retroactive Coverage: Medi-Cal can cover medical expenses from up to 3 months before the month you applied, if you were eligible in those months​. This is called retroactive Medi-Cal. If you have any unpaid doctor or hospital bills in the 3 months prior to your application, be sure to let the county know or indicate it on your application. They will evaluate those past months as well, and if you would have qualified, Medi-Cal will cover those expenses retroactively. You typically need to request retroactive coverage within 1 year of the service date, so don’t delay if you have past bills​.
• Reporting Changes: Once your application is in process (and after you’re enrolled), keep your information up to date. If you move to a new address, get married/divorced, have a baby, or experience a change in income, notify your county Medi-Cal office as soon as possible​. Keeping your contact info current is crucial so that you receive important notices and renewal forms.
• Annual Renewal: Medi-Cal eligibility is renewed yearly, so after you’re approved, you will need to go through a redetermination each year (usually around the same time of year as your initial approval). The county will mail you a renewal form or a notice if they can auto-renew you. Be sure to complete any renewal paperwork by the deadline to avoid interruptions in coverage. (If you keep your income and household info updated, the renewal can often be done automatically via data sources, but you’ll want to watch for the notice.) Missing a renewal can cause a loss of Medi-Cal, but there are grace periods and appeal rights if that happens.
• If Denied: If you are denied Medi-Cal but you believe you qualify, you have the right to appeal the decision (the denial notice will have instructions for a State Fair Hearing). Also, if your income is above Medi-Cal limits, you may be eligible for subsidized health insurance through Covered California. In many cases, the Covered California system will automatically consider you for other programs if Medi-Cal isn’t an option​. So, a denial of Medi-Cal could mean you qualify for discounted premiums on a marketplace health plan instead. Don’t go without coverage – explore those alternatives if needed.

Checking Your Application Status

While you’re waiting for a determination, you might want updates on your application’s status. The best way to check your Medi-Cal application status is to contact your county’s Medi-Cal (social services) office directly​. Each county has access to your case file and can tell you if your application is pending, if any action is needed, or if a decision has been made. You can call the county human services agency (or visit in person) and provide your name, date of birth, or application confirmation number to get a status update. If you applied online through CoveredCA.com, you can also log into your Covered California account – often, the status will show as “Transferred to County” or “Pending Medi-Cal.” Covered California may not have the final status after transfer, so ultimately the county is the authority on your case. Tip: If it’s been several weeks with no word, reach out to the county and mention you’re checking on your Medi-Cal application. Do not submit a second application, as that can cause duplicate records. County representatives can inform you if they need anything further or give you an estimate on when you’ll get a decision. Additionally, if you have an application confirmation or case number from the online system, have that on hand when speaking with them for quicker reference.

Getting Help with the Application

You don’t have to navigate the Medi-Cal application process alone. There are free resources and professionals available to help you complete your application and answer questions:

• Certified Enrollment Counselors (CECs): California has trained enrollment counselors who offer free assistance with Medi-Cal and Covered California applications​. They can help you fill out the forms, either in person or over the phone, and ensure you’ve provided the needed information. You can find local counselors by using the search tool on CoveredCA.com or by calling the Covered California hotline.
• Phone Support: You can call Covered California at 1-800-300-1506 for help with an application​. The operators can assist in multiple languages and connect you with local help. They can also answer basic questions about eligibility and the process. If needed, they will refer you to your county office for more specific case issues.
• County Offices: Your county social services office is a key point of contact. They have eligibility workers who can guide you, especially if you apply in person or by phone. Don’t hesitate to visit or call your county office if you need help gathering documents or understanding any part of the application – they are there to help applicants. Many counties also have community outreach workers or partnerships with hospitals and clinics to enroll people in Medi-Cal.
• Online Resources: The official Department of Health Care Services (DHCS) website (dhcs.ca.gov) has a Medi-Cal Outreach & Enrollment section with information. They provide materials like the “My Medi-Cal: How to Get the Health Care You Need” handbook and FAQs. CoveredCA.com’s support section also has articles specifically about Medi-Cal (for example, how to contact your local office, how to report changes, etc.).
• Language and Accessibility: Medi-Cal and Covered California offer assistance in many languages. Application forms and informational brochures are available in languages such as Spanish, Chinese, Vietnamese, and more​. When calling for help or visiting an office, you can request an interpreter at no cost. There are also TTY lines for the hearing impaired (for instance, Covered California’s TTY is 1-888-889-4500). If you have a disability and need accommodations during the application process, the county can provide assistance (like help with filling forms, or a home visit in some cases).

Bottom line: Applying for Medi-Cal can seem complicated, but there are plenty of supports to make it easier. Take advantage of the free help available, prepare your documents, and don’t be afraid to ask questions. With the above information and resources, you’ll be well on your way to securing Medi-Cal health coverage. Good luck with your application!

Sources:

; California Dept. of Health Care Services – Medi-Cal Eligibility and Enrollment Guides​

; Covered California – Medi-Cal Application Assistance

; San Francisco HSA – Medi-Cal Application FAQ

; etc.