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What is Medi-Cal?

map of California Medi-Cal has been in existence since 1966. It is part of the Medicaid program of the State of California, and it’s funding comes from both the State and Federal Government. This is a kind of government run health insurance program that is designed for low income individuals, disabled individuals, and people with specific kinds of diseases.

To qualify for Medi-Cal, you must already be enrolled in one of the following programs:

SSI/SSP: SSI is Social Security, SSP is State Supplementary Payment. Both are run through the Social Security Administration

CalWorks (AFDC): This is a government program designed to give temporary financial assistance and employment services to families with children who have dropped below poverty level

Refugee Assistance: This is a government run program designed to assist refugees to adjust socially to living here, and to help them gain the skills needed for employment. The idea is to help refugees to become self sufficient as quickly as possible

Foster Care or Adoption Assistance Program: This assists families with the financial aspects of fostering or adopting a child who has special needs. It is part of the U.S. Department of Health and Human Services

In-Home Supportive Services (IHSS): This is a government program designed to help people over age 65, or disabled children, to remain safely in their homes. It provides financial assistance for housecleaning, meal preparation, laundry, grocery shopping, personal care services, and trips to medical appointments.

If you are not currently a part of one of those programs, you may still qualify for Medi-Cal. If you are over age 65, or under age 21, you may qualify. If you are blind, disabled, pregnant, in a skilled nursing or immediate care home, or on refugee status for a limited time, you may qualify. Parents or caretakers of children under age 21 whose parents are deceased, incapacitated, unemployed or underemployed, or do not live with the child, might qualify as well. If you have tuberculosis, breast cancer, or HIV/AIDS, you might also qualify for Medi-Cal. You must be a resident of California to apply for Medi-Cal.

What does it cover? It covers medical and vision care, and some dental care for certain groups of people. You may be required to pay a copay for some care, but this depends on whether or not you have been assigned a Share of Cost (SOC). Your health care provider will let you know if a certain procedure or treatment will be covered by Medi-Cal. You will need to ask your provider about specific coverage. Medi-Cal can be used to help pay for the medical costs that are not covered by Medicare for a person who is over age 65. Your doctor’s office is responsible for submitting any paperwork that may be required in regards to your treatment.

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