Tips for a Successful Medi-Cal Application

Long-term care is expensive, and Americans can’t expect Medicare to pay for it. Given this, Medicaid has, unfortunately, become the long-term-care insurance of the middle class, with some people wiping out their savings and then relying on Medicaid for assistance in paying for their nursing-home stays.

In this blog post, we’ll take a look at the enrollment process for Medi-Cal—the Medicaid program for Californians. Although California is just one state, it is the most populous one and deserves attention. For non-Californians, I recommend the website, which provides eligibility and enrollment information for each state.

What Is Medi-Cal?

Medi-Cal is California’s health insurance program for low-income residents. Along with the Children’s Health Insurance Program, it provides free and low-cost coverage for more than 12 million Californians.

Do I Qualify?

As part of the nation’s recent health care reforms, California has simplified the enrollment process. Covered California, the state’s health insurance marketplace, acts as a one-stop shop for Californians. You provide basic information that will be used to determine whether you are eligible for Medi-Cal or a subsidized policy that you can buy through the health insurance marketplace. In addition, you can still apply for Medi-Cal through traditional channels.

For frequently asked questions on both Medi-Cal and Covered California, visit the California Department of Health Care Services FAQs page. You can also find links to apply through Covered California or your local county office on the department’s Beneficiaries page.

Tips for a Successful Application

Covered California is set up to make enrolling easier than ever. However, here are some tips to help you successfully apply for Medi-Cal, especially if you are doing so via mail or through your county’s social services department.

  • Apply as soon as you think you are eligible. Medi-Cal may be retroactive up to three months.
  • Use a mailing address that you check daily. You will want to respond promptly to any Medi-Cal notices you receive.
  • When mailing information, get documentation. Correspondence can get lost. Keep track of your submissions by mailing everything via certified mail, return receipt requested.
  • Respond promptly to requests for information. If Medi-Cal wants information from you, provide it as soon as possible to speed up the processing of your case.

A few more points to keep in mind:

  • If Medi-Cal denies your case, you can appeal. Working informally with your county office could help you rectify the situation, but filing a formal appeal may be more effective.
  • Be aware of estate recovery issues. In some cases, the estates of Medi-Cal recipients have to pay the program back after their death.
  • Don’t assume you won’t qualify because you have too many assets. The eligibility rules are fairly generous, and many assets are exempt. You can visit Covered California to see whether you are eligible, or visit your local social services office.