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1. 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, by phone, in person at one of the Placer County Human Services offices, or by mail. To apply for Medi-Cal by phone call 1-888-385-5160. If you want to apply by mail, please call 1-888-385-5160 and request an application be sent to your home.

2. How long does the Medi-Cal application process take?

Forty-five 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.

3. Do I have to pay for Medi-Cal?

It depends if the following apply:

• 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.
• Add-If your income is more than Medi-Cal limits for you family size, you will be referred to Covered CA to select a health insurance plan.

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. You can find more information on the Medi-Cal Information Notice 007 (English) and 007 (Spanish). 

4. 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.

5. 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.

6. 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 and B premiums can be used as allowable deductions in the Medi-Cal share of costs calculation.

7. 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 or visit Smile California
• Refer to the California Department of Health Care Services Website 

8. 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.

9. 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 266% 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 more information about services, contact:
Placer County Child Health and Disability Prevention Program
11484 B Avenue
Auburn, CA 95603
Phone: 530-886-3620
Fax: 1-530-889-7140

10. What is the Medi-Cal Access Program (MCAP)?

The Medi-Cal Access Program (MCAP) provides health care to uninsured pregnant women whose income is too high to qualify for no-cost Medi-Cal. Benefits include:

• 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
• Hospital delivery
• Prenatal visits

For more information and an application, call 1-800-433-2611 or visit the MCAP website

11. What is the Women, Infants and Children Supplemental 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 the Placer County WIC Program and the various county offices or by calling 530-889-7211 or 916-784-6447

12. 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 and Treatment (PACT).

To contact the California Office Family Planning Services, call 1-800-942-1054.

13. 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. Check out information on Placer County’s Medical Care Services Program.

14. What is the 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. To find out more information about CCS contact:
Placer County CCS
11484 B Avenue
Auburn, CA 95603
Phone: 530-886-3630
Fax: 530-886-3613
Email CCS

15. 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:

• Accompaniment to medical appointments
• Grocery shopping
• Housecleaning
• Laundry
• Meal preparation
• Personal care services (such as bowel and bladder care, bathing, grooming and paramedical services)
• Protective supervision for the mentally impaired

To apply for IHSS in Placer County, call the IHSS office at 530-889-7115. 

• Medi-Cal Billing Problems:
  • For Problems or Questions Regarding Medical Bills, Call Electronic Data Systems: 916-636-1980
• 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
• 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
• Medi-Cal Beneficiary Fraud and Abuse: 1-800-822-6222
• Provider Fraud and Elder Abuse complaint line: 1-800-722-0432
• SSA or SSI/SSP Information: 1-800-772-1213 (For hearing impaired: TTY 1-800-325-0778)

16. More Program Information and Telephone Numbers

• Medi-Cal Billing Problems:
  • For Problems or Questions Regarding Medical Bills, Call Electronic Data Systems: 916-636-1980
• 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
• 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
• Medi-Cal Beneficiary Fraud and Abuse: 1-800-822-6222
• Provider Fraud and Elder Abuse complaint line: 1-800-722-0432
• SSA or SSI/SSP Information: 1-800-772-1213 (For hearing impaired: TTY 1-800-325-0778)
• The Ombudsman can assist with ensuring that beneficiaries receive all medically necessary, covered services for which plans are contractually responsible. (888) 452-8609
•  Visit the DHCS website for ‘Medi-Cal for Families’ (TLICP) program for information about children with zero SOC Medi-Cal with a monthly premium