Medi-Cal & Medi-Cal Managed Care

Medi-Cal and Medi-Cal Managed Care

Medi-Cal is a California health care program for many people with low incomes.

Medi-Cal has been expanded to adults 19-64 without children and incomes at or below 138% of the federal poverty level (FPL). For example, for the year 2016 this equals a monthly income of $1,367 for an individual and $2,795 for a family of four.

If you were eligible for Medi-Cal starting January 1, 2015, you will be required to choose a Medi-Cal Health Plan.

In Medi-Cal Health Plans, your Plan will help you find doctors, pharmacies, and other providers in the Plan’s network. The government pays the Plan a fee each month to provide your care. You do not pay anything. Medi-Cal Health Plans are also called “Medi-Cal Managed Care Plans.”

To receive medical care in LA County DHS hospital or clinic, you must choose L.A. Care Health Plan or Health Net on your Medi-Cal Choice form from the state.

For more information, click here or call 1-(888) -4LA-CARE or 1 (888) 452-2273.

For Health Net, click here or call 1 (800) 327-0502.”

Who can get it?

  • Adults 19-64 with no children if their income is at or below $1,367* per month
  • Children under 18, up to age 21 if full time student and claimed as tax dependent
  • Parents and Caretaker Relatives
  • Pregnant women, Seniors 65 years and older, Persons with disabilities, Refugees, Individuals in Nursing Homes

How much does it cost?

  • Depending on your family size and income you may have to pay a Share-of-Cost (SOC)*

What is required?

  • California residence
  • Proof of income
  • Citizenship and immigration status determines your  eligibility for full-scope or restricted Medi-Cal benefits
  • Full benefits:  U.S. citizens and Lawfully Present Immigrants
  • Restricted benefits (emergency and pregnancy related services only):  Undocumented aliens, U.S. born individuals unable to verify citizenship and certain other immigrants

What is covered?

  • Most health care services; doctor visits, hospital care, tests, medicines, emergency room visits, surgeries etc.
  • Restricted benefits:  Emergency and pregnancy related services
  • Pregnant women whose property is not counted are eligible to pregnancy related benefits only

How do I enroll?

  • DHS financial workers can help you with the Medi-Cal application process at your nearest LA County DHS hospital or clinic
  • Please bring the following documents with you, if you have them; a current California Driver’s License or ID, Social Security Card and proof of income.  For more information, please go to: https://www.dpssbenefits.lacounty.gov/ybn/Index.html

Where do I apply?

  • Any County hospitals, clinics and welfare office, and other community based organizations
  • Monthly income level above is based on the January 1, 2016 Federal Poverty Levels (FPL) for your family size.

*SOC is the amount of money you are responsible to pay in any month you receive medical services before Medi-Cal begins to pay