Decoder

Medi-Cal

/resources/images/vector.png

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.

Latest Resources

Previous
Tags:

Promise Image
Each piece of content has been rigorously researched, edited, and vetted to bring you the latest and most up-to-date information. Learn more about our content and research process here.
A Navigator is your Partner at each turn
Every Undivided Navigator has years of experience supporting families raising kids with disabilities or parenting their own. Partner with an Undivided Navigator for a free Kickstart to learn first hand what support feels like!
tick-icon
Identify near-term goals and priorities
tick-icon
Develop a vision for your child and family
tick-icon
Map out strategies to execute near- and long-term goals
“It’s so helpful to have one place that you can go to get many answers.”–Leeza Woodbury, with Navigator Kelly since 2020
*Currently offering Navigator Kickstarts to residents of California