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Healthcare Coverage

 

 

 


 

Medi-Cal

Medi-Cal, California's Medicaid program, provides healthcare coverage to low-income residents, ensuring access to necessary medical services. It supports various groups, including adults, children, pregnant women, and older adults or disabled.

Eligibility for Medi-Cal:

  • Must be a U.S. Citizen or Legal Resident and a California Resident.
  • Income must be below 138% of the Federal Poverty Level for adults and 250% for children.

Application Requirements: 

  • Proof of income, property (if applicable) 
  • Citizenship or legal residency 
  • Social Security Number and California residency 
  • Restricted Medi-Cal is available for certain services, such as pregnancy and emergency care, for those without proof of citizenship or legal residency. 

How to Apply:

Online: BenefitsCal.com or CoveredCA.com
In-Person: Visit our office for personal assistance or to apply directly.
333 E Washington Street 
Stockton, CA 95202-3200
Monday - Friday 8am to 5pm
Closed Saturday and Sunday

Telephone: (209) 468-1000

 

 

Who qualifies for Medi-Cal?

Individuals who are potentially eligible for Medi-Cal include those who are:

  • A United States Citizen or Legal Resident, and
  • A California Resident, and
  • In a household with Modified Adjusted Gross Income (MAGI) below 138% of the Federal Poverty Level (FPL) for adults and 250% FPL for children.

*Note: Income levels are different for pregnant women and disabled or elderly populations.

What are the requirements?

Families applying for Medi-Cal must provide proof of:

  • Income,
  • Property (for individual who are blind, disabled, or over 65 years old),
  • Citizenship/legal resident status,
  • Social Security Number,
  • California Residency

Individuals who are unable to provide proof of citizenship/legal resident status may be eligible for restricted Medi-Cal to cover:

  • Pregnancy
  • Emergency services

How can I apply for Medi-Cal?

You can apply for Medi-Cal online at www.benefitscal.com or www.coveredca.com
Or Call Covered CA at: 1-800-300-1506

Or In our office at :

333 E Washington Street 
Stockton, CA 95202-3200
Monday - Friday 8am to 5pm
Closed Saturday and Sunday

Renewing/Continuing Medi-Cal Benefits

When a Medi-Cal application is approved, the first annual Re-Evaluation (RE) will be due in the 12th benefit month. The Re-Evaluation packet will be mailed to the beneficiary during the 10th month from the initial application date or most recent annual re-evaluation effective date.

Can I Get A Doctor Referral Or A List of Providers?

We cannot refer you to individual providers. In San Joaquin County you will be required to select a managed care provider such as Health Plan of San Joaquin or Health Net as your primary care provider. The Health Plan will provide a list of providers to choose from.

Can I Get Help From Medi-Cal With Medicare Costs?

If you are entitled to or receiving Medicare, you may be eligible to payment of your Medicare Part A and/or Part B premiums, deductibles, and co-insurance fees by applying for the Medicare Savings Programs, even if you are not receiving Medi-Cal.
The Medicare Savings Programs are:

Qualified Medicare Beneficiary (QMB)
Specified Medicare Beneficiary (SLMB)
Qualifying Individual (QI)

Eligibility requirements include property and income limits which may change annually.
You can apply for the Medicare Savings Programs online (www.C4Yourself.com) or by coming in to one of our local offices.

Do I Have to Pay For Medi-Cal?

You may have a “Share of Cost” for medical/dental treatment based on your income and family size. When your provider uses your Benefits Identification Card (BIC) to verify your Medi-Cal eligibility, your provider will know if Medi-Cal will pay for a medical/dental treatment or if you need to make a payment to your “Share of Cost” for any treatment.

I Lost My Medi-Cal Card. Where Can I Get Another Card?

If you did not receive your card, lost your card, your card was stolen, or the card you received in the mail has the wrong information on it, you may call and ask for a Benefit Identification Card (BIC) by contacting the BIC Issuance Desk at 209-468-1328

Is There A Special Nutrition Program for Children and Pregnant Women?

More information about the Women, Infants and Children (WIC) program can be found at
www.cdph.ca.gov/programs/wicworks/ or by calling one of the contact centers listed below.

Delta Health Care /WIC: (209)444-8600 or (209)870-5000
Community Medical Center/WIC: (209)870-5000
San Joaquin County Public Health: (209)468-3280

What does Medi-Cal Cover?

Medical, Dental, and Vision services and some prescriptions.

What if I am Disabled?

To get Medi-Cal as a disabled person, you must have severe physical and/or mental problem(s) which will:

Last at least 12 months in a row and,
Stop you from working during those 12 months, OR
Possibly result in death.

You must prove your disabling physical and/or mental problem(s) with medical records, tests, and other medical findings. Or, you must be receiving social security disability income.

What If I'm Pregnant?

If you are pregnant and cannot afford to pay for health care and some dental care, Medi-Cal can help pay for medical expenses for you and your unborn. Many times you can get Medi-Cal at no cost to you, even if you have income.

What is Medi-Cal?

Medi-Cal is California’s version of the Federal Medicaid program, which is designed for low-income families, and individuals.