Medi-Cal Eligibility: What You Need to Know

Medi-Cal is California’s implementation of the Medicaid program. This program is set up to help those in need get the medical care they need without breaking their budget. While this program is commonly focused specifically on the poor, that is not always the case. Understanding the eligibility requirements for Medi-Cal will help ensure you can get the benefits you are entitled to.

Eligibility Based on Income

Anyone is able to enroll with Medi-Cal if their annual household income is at or below the established threshold. The threshold is based on family size and is set at 138% of the poverty level. For an individual, this is $16,395. For a family of three, it is $27,821. For each additional member of a family, the amount goes up by $5,741.

Additional Ways to be Eligible

Regardless of your family income, you can also qualify for Medi-Cal in a variety of other ways, which are as follows:

    • Age (65 or Older or 21 and Under) – Those who are over the age of 65 or under the age of 21 can get on this program.

 

    • Blind – Anyone who is legally blind can qualify for Medi-Cal.

 

    • Disabled – Those with professionally diagnosed disabilities can qualify.

 

    • Pregnant – If you are pregnant you can get on this program throughout your pregnancy.

 

    • Receiving Nursing Care – If you or a loved one has to receive trained nursing care in a long term care facility.

 

    • Refugee Status – If you are in California as a refugee. (There are time limits to this form of eligibility).

 

  • Parent or Caregiver in Certain Situations – If you are the caregiver of a child under the age of 21 who is not yours, you may qualify. This pertains to when the child’s parents are deceased or don’t live with the child, they are incapacitated, or they are under or unemployed.

Are You Enrolled in Other Programs?

One of the easiest ways to determine if you can qualify for Medi-Cal is to see if you are enrolled in any of the following other programs. Those who qualify for these programs will also qualify for Medi-Cal:

  • CalFresh
  • SSI/SSP
  • CalWorks (AFDC)
  • Refugee Assistance
  • Foster Care
  • Adoption Assistance Program

We Are Here to Help

The Medi-Cal program is designed to help those in need. Unfortunately, it is often difficult to determine if you qualify; and even if you are sure you do, the application process can be confusing. What’s worse, many people who apply are denied on their first application even if they should qualify. If you are having difficulties with this program or you just want assistance enrolling, we are here for you. Contact us to schedule a free consultation and see how we can help you today.

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