Undivided: How to Apply for Medi-Cal
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Medi-Cal

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Overview

While Medi-Cal (California's Medicaid program) will always be secondary coverage for children with private primary insurance, it can help with copays and many other out-of-pocket expenses. Learn more about who is eligible, what the Medi-Cal waiver is, and how to appeal a denial of coverage.

What services can Medi-Cal cover?

Common Medi-Cal services include (but are not limited to):

Check out our article Medi-Cal 101 and our Medi-Cal Terms and Services Glossary for more information about what your child might be eligible for.

Contents


Overview

What services can Medi-Cal cover?

How do I choose a managed care plan?

Where do I turn if my claim is denied?

When can I use Medi-Cal as secondary insurance?

Who is eligible for the Medi-Cal waiver?

Related Parent Questions

What does Medi-Cal cover?
Medi-Cal can pay for health care costs, In-Home Supportive Services (IHSS), vision and dental care, and a number of Regional Center services, including respite, behavioral supports, and other therapies and programs.
Who is eligible for Medi-Cal?
Eligibility for Medi-Cal is usually based on household income. However, California offers several programs that allow people with disabilities to obtain Medi-Cal if their income is too high to qualify based solely on financial need.
Do I need a Medi-Cal managed care plan?
On January 1, 2022, a program called CalAIM went into effect. Among other things, the program is designed to streamline the delivery of Medi-Cal services in the community. Going forward, only those with medical exemptions will be eligible to remain under fee-for-service Medi-Cal.
Can I use Medi-Cal as secondary insurance?
Families who already have health insurance coverage for their child can still benefit from Medi-Cal as it may be used as a secondary insurance to pay certain expenses that a primary health insurance doesn’t cover.
What can I do if Medi-Cal denies my claim?
If Medi-Cal denies coverage for something your child needs, you are entitled to an appeal. The appeal process changes depending on whether you are enrolled in a managed care plan or straight Medi-Cal.
What is the Medi-Cal institutional deeming waiver?
Medi-Cal's institutional deeming waiver is designed for individuals with developmental disabilities regardless of parental income, as long as your child’s personal income and resource levels fall below program thresholds.
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