Medi-Cal Program

Pregnancy Services

You may be eligible for Medi-Cal to pay for medical expenses for yourself and the baby if you are pregnant and cannot afford to pay for health care during pregnancy, and for the baby's first year of life. Medi-Cal is often available at no cost to the mother even if she has income. Increases in family income will not count after Medi-Cal pregnancy-related services are approved.

Children

Children may get Medi-Cal at no cost if income requirements are met.  There are different programs available for infants, for children ages 1 through 6, and for children ages 6 through 19.

Confidential Medical Services for Minors

Confidential medical services are available to unmarried persons under age 21 and living with their parents. Parental consent is currently not needed under the Minor Consent program. Medical services covered under this program are those relating to family planning, pregnancy, drug/alcohol abuse, venereal and other sexually transmitted infections, sexual assault, and outpatient mental health services for sexual or child abuse.

Eligibility for Medi-Cal

Families of any size are eligible if they meet eligibility guidelines. The following persons may be eligible:

• Children under 21 years of age.
• Persons 65 years of age and older.
• Disabled and blind persons.
• Pregnant women.
• Families where at least one child is under 21 and at least one parent is absent, disabled, unemployed or working (depending on hours worked and income earned).
• Anyone who is eligible for CalWORKS, Supplemental Security Income and State Supplemental Program (SSI/SSP), or Entrant or Refugee Cash Assistance (ECA or RCA).
• Families with working parents may qualify if their employer does not provide health insurance; they will have to pay a small share of their medical expenses.
• Persons in a skilled nursing or intermediate care home.
• Individuals who have been screened for breast and/or cervical cancer (Breast and Cervical Cancer Treatment Program)

Even if you are working, own a house, or are married, you may be eligible for Medi-Cal programs that help pay medical expenses. Any person has the right to apply. Certain conditions must be met to qualify. It is important for anyone in need of medical assistance to contact the Placer County Human Services Division because a variety of factors must be considered.

Where to Apply

The Medi-Cal program for Placer County residents is administered by the Placer County Human Services division. If you would like to apply for the Medi-Cal Program you may do so online, by telephone, in person, or by mail. This program provides eligible applicants with a Medi-Cal Benefits Identification Card (BIC) that may be used for services at participating pharmacies, hospitals, and doctor's offices.

What to Bring

The following items of verification (if applicable) are required to process your application:

• A picture identification card
• Social Security card
• Proof of US citizenship
• Non-custodial parent's Social Security number (for child support cases)
• Rent and utility receipts
• Vehicle registration
• Income and property verification such as checking and savings account statements.
• Place of employment
• Home and work address
• Date of birth
• Any prior court order information
• If you are not receiving CalWORKS, your most recent employment information will also be required.

FAQs

• How do I apply for Medi-Cal?
• How long does the Medi-Cal application process take?
• Do I have to pay for Medi-Cal?
• What benefits does Medi-Cal provide?
• I have Medicare. Can I apply for Medi-Cal also?
• Can I get help from Medi-Cal with Medicare costs?
• What services does Medi-Cal cover?
• Is there a special program for children and pregnant women?
• What is the Child Health and Disability Prevention (CHDP) Program?
• What is the Access for Infants and Mothers (AIM) Program?
• What is the BabyCal?
• What is the Women, Infants & Children Supplement Nutritional Program (WIC)?
• What is the Family Planning Services program?
• Are there county-operated health care programs?
• What is California Children Services (CCS)?
• What is In-Home Supportive Services?
• More program information telephone numbers.

How do I apply for Medi-Cal?	There are four ways that you can apply for Medi-Cal in Placer County. You can apply online at www.bcwcalwin.org, by phone, in person at one of the Placer County Human Services offices, or by mail. To apply for Medi-Cal by phone call: (888) 385-5160. If you want to apply by mail, please contact (888) 385-5160 and request an application be sent to your home. Back
How long does the Medi-Cal application process take?	Forty-five (45) days are allowed to process a Medi-Cal application not involving a disability. If you are applying for Medi-Cal based on a disability, your application process may take up to 60 days or longer depending on how quickly you complete the disability information and how quickly your doctors and hospitals submit your medical records. To avoid delays in the processing of your case, submit all information requested of you as soon as possible. Ask your program specialist for help if you are having trouble obtaining information. Back
Do I have to pay for Medi-Cal?	It depends. If your income is less than Medi-Cal limits for your family size, you will receive Medi-Cal services at no cost to you. If your income is more than Medi-Cal limits for your family size, you will have to pay a certain amount only in the month you have medical expenses. The amount that you pay is called your share of cost (SOC). When you pay or promise to pay that amount, we say that you have met your SOC. Once you have met your SOC, Medi-Cal will pay the rest of your covered medical bills for that month. For example, if your SOC is $50, you must first pay or obligate (obtain your providers agreement to make payments on the SOC) $50. Your provider will enter the amount you paid or obligated into the Department’s database. Your case will certify when the amounts you paid or obligated equal the amount of your share of cost. Once your share of cost is certified; providers checking your eligibility will advised that you are eligible and covered services may now be billed to the Medi-Cal program. Please note, expenses incurred by ineligible members of your family may be used to meet the share of cost of eligible members. If one spouse lives in a nursing home, Medi-Cal allows the spouse remaining in the home to keep all of the income he/she receives in his/her name regardless of the amount. Be sure to ask Placer County Human Services for an MC Information Notice 007 for more information on income.  Back
What benefits does Medi-Cal provide?	Medi-Cal provides medical, vision and dental services for people with full-scope benefits. A person can be eligible for full-scope Medi-Cal benefits if she/he is a U.S. citizen or a legal permanent resident alien and meets other eligibility criteria. Restricted benefits provide emergency services to individuals without satisfactory immigration status. Restricted benefits allow a person to use her/his Medi-Cal for emergency services only. For a pregnant woman with restricted benefits, Medi-Cal will cover pregnancy-related services only. Based on a person's family size and income, a person may have to pay a share of cost (SOC) to the provider each month if Medi-Cal is used. A person with zero SOC pays no portion of the medical expenses whether or not Medi-Cal is used. Back
I have Medicare. Can I apply for Medi-cal also?	Yes. Individuals who are Medicare beneficiaries may apply for Medi-Cal. If Medi-Cal eligibility is established, the State may begin paying the Part B premium and the Part A and B coinsurance and deductibles. The State will also pay the Part A premium for Medicare beneficiaries who are not qualified for free Part A benefits. Medi-Cal may also provide medical services that are not covered by Medicare.  Back
Can I get help from Medi-Cal with Medicare costs?	Yes. Medicare is different from Medi-Cal. Medicare is a federal health insurance program run by the Centers for Medicare and Medicaid Services. It is available to most people 65 years of age or older and certain disabled or blind persons, regardless of income. Medicare Part "A" covers hospitalization. Medicare Part "B" covers doctor bills. If you receive Medicare, you may qualify for the following special Medi-Cal programs: The Qualified Medicare Beneficiary program pays for the Medicare Part A and B premiums, co-insurance and deductibles. To be eligible you must have income at or below 100% of the Federal Poverty Level. The Specified Low-Income Beneficiary and Qualifying Individual 1 program pay for all or some of the Medicare Part "B" premium. To be eligible you must have income below 135% of the Federal Poverty Level. The Qualifying Individual 1 program reimburses you for a portion of your Medicare Part "B" premium that you have paid. To be eligible you must have income below 135% of the Federal Poverty Level. The Qualified Disabled Working Individual program pays the Medicare Part "A" premium. To be eligible you must have income at or below 200% of the Federal Poverty Level, be disabled, be employed and eligible under any other Medi-Cal program. Even if you don’t qualify for the above assistance programs, your Medicare A & B premiums can be used as allowable deductions in the Medi-Cal share of costs calculation.  Back
What services does Medi-Cal cover?	For information about the services Medi-Cal covers: • Call your provider (your doctor, dentist, clinic, hospital, etc.) • For questions about dental services or Medi-Cal dental programs (Denti-CAL) call 1-(800) 322-6384.  Back
Is there a special program for children and pregnant women?	Yes. Pregnant women and children may have more income and property than other people and still qualify for no-cost Medi-Cal services. The income guidelines are different for children under age 1, children 1 to 6, and children 6 to 19. Your family property, such as savings accounts or cars, is not used to determine eligibility if monthly income falls within certain limits.   Back
What is the Child Health and Disability Prevention (CHDP) Program?	The Child Health and Disability Prevention (CHDP) Program is a health promotion and prevention program serving California’s infants, children, and teens. The CHDP Program provides periodic preventive health assessments to: Children under age 21 with Medi-Cal. Non-Medi-Cal eligible children from birth to age 19 with family incomes at or below 200 per cent of the Federal Income Guidelines and no source of health care coverage for preventive health care services. Children enrolled in Head Start and state preschool programs. Children identified with suspected problems after a health assessment are referred for necessary diagnosis and treatment. Many problems can be prevented, corrected, or reduced in severity by prompt diagnosis and treatment. Early, Periodic, Screening, Diagnosis and Treatment (EPSDT) services are a benefit provided through the CHDP Program for Medi-Cal children not enrolled in a Medi-Cal managed care plans. Call 1 (800) 433-2611 for more information. For more information about services, contact Placer County CHDP 11484 B Avenue Auburn, CA 95603 Phone: (530) 886-3620 Fax: (530) 886-3306     Back
What is the Access for Infants and Mothers (AIM) Program?	The Access for Infants and Mothers (AIM) program provides health care to uninsured pregnant women whose income is too high to qualify for no-cost Medi-Cal. To qualify for AIM, you must be less than 30 weeks pregnant when you apply. AIM benefits include: Prenatal visits Hospital delivery Full health care services during the pregnancy and for 60 days following the child’s birth Full health care services for the baby from birth to age two. For more information and an application, call 1 (800) 433-2611.   Back
What is the BabyCal?	BabyCal encourages pregnant women and their families to get early and ongoing prenatal care and to practice healthy behaviors throughout the pregnancy (no smoking, drinking, or drugs). For information about BabyCal call 1 (800) BABY-999 (1 (800) 222-9999) or click here.   Back
What is the Women, Infants & Children Supplement Nutritional Program (WIC)?	The WIC program is for low to medium income families who have: Women who are pregnant, breastfeeding, or just had a baby Children under 5 years of age Foster children receiving Medi-Cal. The WIC program provides: Checks to buy healthy foods Nutritional counseling, and nutrition education classes Breast feeding support and education For more information in Placer County, please contact: Placer County WIC Program 11484 B Avenue Auburn CA 95603 Phone: (530) 889-7187 Toll Free: (800) 829-.7199 ext. 7187 Email: PlacerWIC@placer.ca.gov                                       Back
What is the Family Planning Services Program?	With Family Planning Services you will: Receive information and education on your options for birth control Discuss with your provider the birth control method that is best for you Receive Family Planning Services at low or no cost. With Family Planning Services you can: Receive continued follow-up care Prevent unplanned pregnancies Plan when to have your next child. Family Planning Services can give you: Birth control supplies for men and women Pregnancy tests Breast and cervical cancer screening Tests and treatment for sexually transmitted infections (STI) Education, testing, and counseling for HIV, the virus known to cause AIDS. If you are low-income or are receiving Medi-Cal, Family Planning Services are available at no cost. You can get Family Planning Services from: Your regular Medi-Cal health care plan, doctor, or community clinic. Or, any other doctors or clinics that accept Medi-Cal. Health care providers who participate in Family Planning, Access, Care & Treatment (PACT). To contact the California Office Family Planning Services, call 1(800) 942-1054.   Back
Are there county-operated health care programs?	Yes. Individuals who are not eligible for Medi-Cal may qualify for a health care program offered by Placer County. Click here for information on Placer County’s Medical Care Services Program (MCSP).   Back
What is California Children Services (CCS)?	California Children’s Services (CCS) is a statewide program that arranges, directs, and pays for medical care, equipment, and rehabilitation, when these services are authorized by the program. Services can be authorized for children and young adults less than 21 years of age who have eligible medical conditions and whose families are unable to pay for all or part of their care. CCS defines eligibility and selects the most qualified professionals to treat the child’s CCS-eligible condition. However, it is important for you to know that CCS is not a health insurance program. It will not meet all of the child’s health needs, only those related to the CCS-eligible condition. Click here to find information about CCS in Placer County, or contact: Placer County CCS 11484 B Avenue Auburn, CA 95603 Phone: (530) 886-3630 Fax: (530) 886-3613 Email: teamccs@placer.ca.gov    Back
What is In-Home Supportive Services?	The In-Home Supportive Services (IHSS) program helps pay for services which enable individuals to remain safely in their own homes instead of entering a nursing home or board and care facility. To be eligible, you must be over 65 years of age, disabled, or blind, and eligible for Medi-Cal. Disabled children are also eligible for IHSS. The types of services IHSS can help pay for include: Housecleaning Meal preparation Laundry Grocery shopping Personal care services (such as bowel and bladder care, bathing, grooming and paramedical services) Accompaniment to medical appointments Protective supervision for the mentally impaired. To apply for IHSS in Placer County, contact the IHSS office at (530) 889-7240 or (916) 787-8800.   Back
More program information telephone numbers.	1. Prepaid Health Plans/Managed Care:  To Enroll/Dis enroll Call MAXIMUS, the State’s Health Care Options Contractor: 1 (800) 430-4263 To File A "Plan Specific" Complaint Call your specific Health Plan If You Are Not Satisfied, Call The State Office Of The Ombudsman: 1 (888) 452-8609 2. Medi-Cal Billing Problems:   For Problems Or Questions Regarding Medical Bills, Call Electronic Data Systems: (916) 636-1980 3. Medi-Cal State Hearing: To file a request for a Medi-Cal State Hearing: Call the Public Inquiry and Response Unit at 1 (800) 952-5253; For Hearing Impaired: TDD 1 (800) 952-8349 4. Third Party Liability: Health Insurance Billing and Coding, Premium Payment, Medicare Buy-in: 1 (800) 952-5294 Casualty, Personal Injury, Probate, Estate, Liens, Workers’ Compensation, Overpayment Recovery: 1 (800) 952-5294. 5. Medi-Cal Beneficiary Fraud and Abuse: 1 (800) 822-6222 6. Provider Fraud and Elder Abuse complaint line: 1 (800) 722-0432 7. SSA or SSI/SSP Information: 1 (800) 772-1213         (For hearing impaired: TTY 1 (800) 325-0778 8. Other Health Program Numbers:     For Healthy Families/Medi-Cal for Children application and/or information: 1 (888) 747-1222.                  Back

To report Medi-Cal fraud, please call 800.822-6222.