Below are answers to frequently asked questions regarding Medi-Cal. For more information, click here
Q: Where do I apply for Medi-Cal in Stanislaus County?
A: Call 1-800-962-4468 to have a Medi-Cal application sent to your home. Medi-Cal eligibility staff may also be able available to take applications at some clinics and hospitals. If you want to apply in person, the following offices accept Medi-Cal applications:
Community Services Agency (CSA)
251 E. Hackett Road
Modesto, CA 95358
101 Lander Avenue
2413 3rd Street
West Modesto Community Center
401 Paradise Road, Bldg. E
2201 Morrill Road
1014 Scenic Avenue
Q: How do I apply for Medi-Cal benefits?
A: Call 1-800-962-4468 to have a Medi-Cal application sent to your home, or go to the nearest Medi-Cal office. You can also downloaded an application at http://www.dhs.ca.gov/mcs/medi-calhome/mc210.htm If you have an immediate need for health care services (such as severe illness or pregnancy) bring the completed application to any Community Services Agency office. Tell the worker that you have an immediate for medical or dental care. They will process your application as fast as possible. Fill out the forms as completely as you can, Section 9 called "What Do I Need for Verification?" tells you what proof to give when you apply for Medi-Cal. You can speed up the process by providing the necessary information and paperwork quickly.
Q: Do I have to come into the office to get benefits?
A: No, in most cases a face-to-face interview with a case manager is not required. You can obtain an application through the mail by calling our Medi-Cal application line at 1-800-962-4468 or down load an application at http://www.dhs.ca.gov/mcs/medi-calhome/mc210.htm
Q: What happens when I call the application line?
A: A clerk will take down your contact information and ask you a few questions over the phone. An application will be mailed to your mailing address and an intake worker will be assigned to you. The application will include a cover letter with the worker's name and phone number in case you have any questions about completing the application. You can complete the application at home and mail it back with any verifications (proof) needed. The worker will review your completed application and request additional verifications or information if needed, to determine your eligibility to Medi-Cal benefits. In some circumstances if you need help completing the application and are disabled and cannot come into the office, we may do a home visit or phone interview.
Q: What are some requirements to be eligible for Medi-Cal?
A: Medi-Cal has several different programs so each person's circumstances are unique but in general, if you are in a skilled nursing facility, or expecting to enter a skilled nursing facility, or under age 21, or over age 65, or legally blind, or have a disability that is expected to last a year or more, or have a child under 21 who does not have the support or care of one parent because of that parent's absence from the home, death, incapacity or unemployment you may be considered Medically Needy and should apply for Medi-Cal if you need help meeting your medical expenses. You must also be a resident of Stanislaus County, and willing to provide your Social Security number, immigration/citizenship status, and information about your income, property, and other health insurance if any.
Q: What do I need for verification (proof)? What if I don't have proof?
A: You may apply without proof, but you will have to give certain information before your Medi-Cal can be approved. Your worker will tell you what proof is needed. If you can not get the proof yourself ask your worker to help you. Here is a list of some of the items required:
? Social Security card(s)
? Medicare card(s)
? Naturalization documents(s)
? Alien registration card(s)
? Pregnancy verification
? Income verification
? Property Tax statements for all real property
? Vehicle registration(s)
? Bank Account statement(s) and Trust Account document(s)
? Stocks, Bonds (including US Savings Bonds), and Mutual Funds
? Life Insurance policies including Cash Surrender Value (CSV) tables.
? Documentation regarding the current value of Annuities, IRAs and Trusts
? Burial trust(s), prepaid burial contract(s) and information on burial plot(s).
Q: If I have other health insurance or Medicare can I still get Medi-Cal?
A: Yes, you can get Medi-Cal, even if you have other insurance or Medicare. Medi-Cal may pay for the deductibles and co-payments that are not covered by your insurance. Some Medi-Cal programs can help pay for your Medicare premiums.
Q: I can no longer afford to pay my health insurance premiums, can Medi-Cal help me?
A: If you have are eligible to Medi-Cal and have a very high-cost medical condition, you may qualify for assistance under the Health Insurance Premium Payment Program (HIPP). There are specific requirements for this program and not everyone who applies is approved. For more information call HIPP at 1-866-298-8443.
Q: Do I have to have children to be eligible for Medi-Cal benefits?
A: No. Adults without dependents may apply for and be eligible for Medi-Cal benefits if they are:
? 65 or older or
? have a disability that is expected to last a year or more
? are legally blind
? in long term care at a skilled nursing facility
Q: Do I have to be a U.S. citizen to get Medi-Cal?
A: No, but you have to be an eligible non-citizen (have the legal right to be in the U.S.) to get full scope benefits. If you are an undocumented non-citizen you may be eligible to emergency only services.
Q: How much income can I get and still get Medi-Cal?
A: You can get Medi-Cal regardless of how much money you get. However, the more income you have the more you may have to pay as a Share of Cost (SOC) before Medi-Cal will help pay for your medical bills.
Q: How much property can I have and get Medi-Cal?
A: The property/asset limits vary depending on household size and program starting at $2,000 for an individual and $3,000 for a couple. Some property is exempt, such as one vehicle, furniture, other personal items, burial plots, and the home you live in. A person in Long Term Care may allocate income and property to the spouse at home. The amounts that can be allocated can every year in January. You should apply and let your case manager determine if you are property eligible.
Q: My minor grandchildren just moved in with me. Can I get Medi-Cal just for them?
A: Yes, you have the option of requesting Medi-Cal only for your grandchildren, or for yourself and your grandchildren. If you choose to apply only for your grandchildren your income and property will not be considered in determining their eligibility to benefits.
Q: I live with my adult daughter and her family; can I get Medi-Cal just for me?
A: Yes, you can apply for Medi-Cal just for yourself. If your daughter needs Medi-Cal for herself, or her family she would apply separately if she is over 21.
Q: How much money can I expect to get for my medical expenses each month?
A: Medi-Cal does not give you money for your medical expenses. The amount of Medi-Cal benefits a household receives depends on household members' income, household size, and many other circumstances. Your worker will carefully review your circumstance to try and give you the lowest possible Share of Cost (SOC). If you qualify for Medi-Cal with a zero SOC your Doctor, Pharmacist, or other medical provider can bill Medi-Cal directly for your treatment or prescriptions that are covered by Medi-Cal. If you have a Medi-Cal with a SOC you will need to meet the SOC amount each month before Medi-Cal picks up the remaining part of the bill.
Q: If I receive SSI/SSP, am I eligible to receive Medi-Cal?
A: Yes. The state of California automatically provides Medi-Cal for SSI/SSP recipients. You do not need to apply for Medi-Cal separately.
Q: Can I receive Medi-Cal if I am homeless?
A: Yes, if you meet all the other criteria for Medi-Cal benefits. You will be asked to provide a contact address/phone number or you may use the Community Services Agency's address if you cannot provide an alternate contact.
Q: Must I have a stable address? What if I move around a lot?
A: You can receive Medi-Cal even if you move frequently as long as you are a resident of Stanislaus County. If you are eligible for Medi-Cal and you change your address, you must inform your case manager within 10 days.
Q: How do I access my Medi-Cal benefits?
A: Medi-Cal benefits are accessed through a Benefit Identification Card (BIC). The BIC works much like any other insurance card. The medical provider will be able to tell whether you are eligible, if you have other insurance that must be billed first and how much your Share of Cost (SOC) is, if any. You should show your BIC anytime you receive medical services or prescriptions, even if you have a SOC. Always find out if the medical provider takes Medi-Cal patients before you go for treatment.
Q: How do I find a dentist or doctor who accepts Medi-Cal patients?
A: Contact Delta Dental office for dental referrals at 1-800-322-6384 or you can find a Denti-Cal dentist on line at http://www.denti-cal.ca.gov/WSI/ProvReferral.jsp?fname=ProvReferral
Contact your local medical society for providers who take Medi-Cal patients. In Stanislaus County:
Stanislaus Medi-Cal Society (209) 527-1704 or online at
2339 Saint Pauls Way http://www.stanislausmedicalsociety.com
Modesto, CA 95355
Q: What Kinds of services are covered by Medi-Cal?
A: Some services require prior approval by Medi-Cal before you can get them. Your provider will know when you need prior approval and how to request it. Medi-Cal may cover the following services:
Doctor's visits and clinical exams
Dental services including exam, x-rays, cleaning, preventive services, fillings
Eye exams, glasses, and eye appliances
Laboratory, X-ray, and radiation treatment
Blood and blood derivatives
Prenatal care if you are pregnant
Prescriptions (If you have Medicare, apply for Medicare Part D to cover most of your prescriptions.)
Durable medical equipment and supplies
Ambulance and other medical transportation
Artificial limbs, braces and eyes, hearing aids
Inpatient hospital care
Hemodialysis (kidney treatment)
Skilled nursing home care
Some services are usually restricted to no more than two per month, they are:
Q: My Benefit Identification Card (BIC) does not work, can you help me?
A: The BIC may not work for various reasons, such as the card may not be active, or the requested services aren't a Medi-Cal covered benefit. You may call your case manager or (209) 558-2777 for assistance.
Q: What happens if I lose my Benefit Identification Card (BIC)?
A: Contact your case manager, go into your local office, or you may request a new card by calling (209) 558-2777.
Q: What do I do if I move to another county/state?
A: Anytime you move, you must contact your case manager within 10 days to report your new address. If you move to another county, since you are still a resident CA, your Medi-Cal case will be transferred to the new county. If you move out of state, you will have to apply for Medicaid in the new state in which you live.
Q: Can I get emergency medical or dental services if I am out state temporarily?
A: Always take your Benefit Identification Card (BIC) with you when you travel outside of CA. Eligibility can be verified by contacting Fiscal Intermediary at (916) 636-1960. The provider may get information on coverage, authorization and billing procedures by contacting the following:
Medical Services Dental Services
California Dept. of Health Services Delta Dental
Medi-Cal Field Office Denti-Cal
PO Box 193704 11155 International Drive, Building C
San Francisco, Ca 94199-3704 Rancho Cordova, CA 95670
(415) 904-9600 1-800-541-5555
Q: If I'm not eligible now, can I apply later?
A: Yes, you may apply for Medi-Cal at any time.
Q: Where can I get more information regarding the Medi-Cal program?
A: For online information:
|Make a Service Request for Medi-Cal|