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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?
Understand the Medi-Cal Institutional Deeming Waiver. Learn how it benefits individuals with developmental disabilities.

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Author

Brittany OlsenUndivided Editor

An editor and cartoonist who loves using words and images to simplify and share ideas. She has ten years of experience as a copy editor and lives near Portland, Oregon. She often spends her free time going on nature walks with her dog or trying new bread recipes.

Reviewed by

Jennifer Drew, Undivided Senior Editor


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