· Are minors in need of confidential treatment for drug and/or alcohol abuse, sexually transmitted diseases, sexual abuse, pregnancy, family planning or mental illness

· Have tuberculosis (for citizens and documented non-citizens only)

· Have Medicare (for payment of the Medicare premium)

· Have had an organ transplant in the previous two years and need anti-rejection medication¥

To see the Department of Healthcare Services (DHCS) income to family size chart click here.

3. Will my family and I qualify for the same program?

Depending on your household size or family income, you or your family may qualify for different programs. For example, you may qualify for affordable private health insurance available through Covered California. However, your child may qualify for free Medi-Cal. †

4. What information may I be asked for?

You may be asked the following details about each person in your household:

· Age

· Income

· Employment

· Identification

· Marital Status

· Citizenship

The information required for each family member depends on their age, disability status, and other factors.

5. How much does Medi-Cal cost?

For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out-of-pocket cost. Some households will see affordable costs, such as a low monthly premium. For some Medi-Cal children, the monthly premiums are $13 per child up to a family maximum of $39 per month. In general, individuals in Medi-Cal will get the same health benefits available through Covered California at a lower cost.†

6. 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:

A. Qualified Medicare Beneficiary (QMB)

B. Specified Low Income Medicare Beneficiary (SLMB)

C. Qualifying Individual (QI)

D. Eligibility requirements include property and income limits which may change annually.

You can apply for the Medicare Savings Programs online (https://benefitscal.com/) or by coming into one of our local offices.±

In San Bernardino County you will be required to select a managed care provider such as Molina or the Inland Empire Health Plan as your primary care provider.± Every county’s Medi-Cal plans to provide the same high-quality care at the same low or no cost to Californians, no matter where you live. †

7. What health providers are available through Medi-Cal in San Bernardino County?

8. Is there a deadline to enroll in Medi-Cal?

No. There is no deadline to enroll in Medi-Cal. You can apply at any time during the year. When you are determined eligible for Medi-Cal, your eligibility goes back to the month of your application.† Please note, your application may take a couple of months to process. You may help to speed up the process by responding timely to any questions or requests from the County officer who reviews your application.

9. Can I apply for CalFresh at the same time I apply for Medi-Cal?

Yes. Qualified healthcare enrollers can assist you with applying for both CalFresh and Medi-Cal during the same phone appointment. (Mention that you are interested…)

10. I previously was denied Medi-Cal due to owning a car. Do I qualify now?

The Affordable Care Act simplified financial eligibility requirements for Medi-Cal program eligibility. Under these simplifications, “property” such as a car, is no longer counted. You should apply for health coverage even if you previously were determined to be ineligible for Medi-Cal coverage and even though you may think your financial situation has not changed. †

11. If I sign up for Medi-Cal, will anything happen to my assets?

Medi-Cal only tries to recover its costs for medical assistance after your death when a recipient is over age 55, or when a member of any age is cared for at an institution, such as a nursing home. Medi-Cal does not seek payment during your lifetime or the lifetimes of your surviving spouse, disabled son, or daughter, or while your child is under 21 years of age. If you are under 55, you can sign up for Medi-Cal knowing that nothing will happen to your assets unless you are institutionalized. For those over age 55 or in an institution, the Department of Health Care Services may present a claim for the cost of your care. It would be paid from your estate at the time of your death. For more information, please visit Third Party Liability. †

12. I just found out I am pregnant. Can I apply for health insurance that will cover me during my pregnancy?

Yes. Make sure to answer yes to the application question “Are you pregnant?” or tell the person helping you to fill out your application. You can apply for health insurance that can cover pre-natal care, labor and delivery, and postpartum care. Health insurance plans can no longer deny health insurance if you are pregnant. † If possible, apply as soon as you can. It is never too early to apply.

13. I just had a new baby. What should I do about health insurance?

If you did not have Medi-Cal or the Medi-Cal Access Program at the time of delivery, fill out this application for your newborn. If you did have Medi-Cal or the Medi-Cal Access Program during your pregnancy, you do not need to fill out this application. Call your county worker to make sure your baby is covered from birth, or fill out a newborn referral form. Print the MC 330 form. If you had coverage under the Medi-Cal Access Program download an Infant Registration Form, or call, 1-800-433-2611. †

14. How do I locate my local TAD office?

Use this site to insert your zip code or city and find your local office.

15. How do I detect Medi-Cal scams?

If you suspect a Medi-Cal scam or fraud please review some of these common characteristics. Additionally, you may call 1-800-822-6222 to report fraudulent activity.

16. What is BenefitsCal? How do I create an account on BenefitsCal? How do I link my account to my Medi-Cal application? How do I update my account to stay informed on my application status and redetermination of eligibility?

¥ “Medi-Cal.” n.d. Accessed January 30, 2023. https://www.sbcounty.gov/Uploads/HS/TAD/tad000411m.pdf.

† “Medi-Cal and Covered California Frequently Asked Questions.” n.d. Www.dhcs.ca.gov. https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-Cal_CovCA_FAQ.aspx.

± “Medi-Cal – TAD.” n.d. https://wp.sbcounty.gov/tad/programs/medi-cal/.

Frequently Asked Questions

1. What benefits are available through Medi-Cal?

2. Who may be eligible for Medi-Cal?