Medi-Cal is California's Medicaid Program

Medi-Cal is California’s Medicaid Program

Medi-Cal is California’s Medicaid program. This public health insurance program provides free or low-cost medical services for children and adults with limited income and resources. It covers about 14 million Californians, or approximately one-third of the state’s population. More than 80% of Medi-Cal enrollees receive their health care through a managed care plan, with the remaining 20% receiving care on a fee-for-service basis.

Medi-Cal is California's Medicaid Program


In July 2015, over seven million Medicaid California beneficiaries were enrolled in managed care plans. This expanded coverage was made possible through a partnership between the California Department of Health Care Services (DHCS) and the Centers for Medicare and Medicaid Services. These managed care plans provide complete healthcare services for dual-eligible beneficiaries.

In addition to medical coverage, Medi-Cal also covers prescription drugs and rehabilitation services.

Medi-Cal coverage in California is offered through a managed care plan that requires members to have a primary care physician. This physician is the person who will see the patient for medical treatment. To receive Medi-Cal coverage, the physician must refer the patient to a hospital that accepts Medi-Cal.

Medi-Cal’s managed care program

California is beginning a new process for selecting health plans that provide Medi-Cal coverage. Under the new rules, nine commercial insurers will compete for new contracts and have to meet stricter quality-of-care standards. Commercial insurers account for less than one-third of Medi-Cal’s managed-care enrollees, but the state has made nearly $3 billion from these plans since 2014. Federal and state taxes fund the program. California residents can apply for Medi-Cal at any time of the year. Beginning May 1, 2022, immigration status will no longer be a factor in eligibility for Medi-Cal.

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Medi-Cal’s income requirements

Medi-Cal is a state program that provides comprehensive health coverage to low-income individuals and families. Your eligibility depends on your income and how many people are in your household. You must earn less than 138% of the federal poverty level (FPL) to qualify for Medi-Cal.

Medi-Cal’s income requirements vary from state to state and may include a higher income threshold for pregnant women, who are not expected to earn as much as an average adult. For example, pregnant women have an income limit of 213% of FPL, which translates to a $28,968 annual limit. However, several smaller programs within Medi-Cal offer less stringent income requirements.

Medi-Cal’s income requirements can change over time, so checking your application carefully each month is essential. If you have a change in income, it’s necessary to report it to the insurance company.

Medi-Cal’s benefits

Medi-Cal’s benefits are available to low and moderate-income families in California. Eligibility depends on your income, household size, and countable property. You can be eligible for Medi-Cal if you earn less than $17,250 per year or meet specific income requirements—especially if you are pregnant, have children, or have a disability. You can apply online or through your county social services office. If you don’t feel confident in filling out an application, you can visit a local office for personal assistance.

Medi-Cal is a program that pays medical expenses for low-income, elderly, or disabled people. It also covers prescription drugs, rehabilitation services, and more. It is part of the national Medicaid program and is funded with federal, county, and state money.

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Medi-Cal’s challenges

Medi-Cal reform in California is designed to address the challenges faced by low-income patients. These challenges include homelessness, poverty, and substance abuse, which affect a person’s health.

The new changes will be implemented over five years. The first phase began in January of this year, and the ongoing changes will be phased in every year until 2027. The changes will impact both Medi-Cal members and healthcare organizations. The new contracts require plans to meet stringent quality and health equity goals and provide enrollees with transparent, accountable care.