User:Abbyroman/Medi-Cal

Legend:

Original Text

My Edits

Copyediting

Medi-Cal provides health coverage for people with low income and limited ability to pay for health coverage, including the aged, blind, disabled, young adults and children, pregnant women, persons in a skilled nursing or intermediate care home, and persons in the Breast and Cervical Cancer Treatment Program (BCCTP). People receiving federally funded cash assistance programs, such as CalWORKs (a state implementation of the federal Temporary Assistance for Needy Families (TANF) program), the State Supplementation Program (SSP) (a state supplement to the federal Supplemental Security Income (SSI) program), foster care, adoption assistance, certain refugee assistance programs, or In-Home Supportive Services (IHSS) are also eligible.

As a means-tested program, Medi-Cal imposes asset limits on certain prospective enrollees. Medi-Cal individuals who receive long-term supportive services or who enroll in Medi-Cal through certain disabilities are subject to asset tests. This limit depends on the number of individuals being considered for coverage; for one enrollee, this limit is $2,000, while for two enrollees, the limit is $3,000. Each additional individual being considered results in an additional $150 of permitted assets, up to a total of ten individuals covered. If applicants possess property whose total value exceeds the allowed amount, they are required to reduce ("sell down") their assets through activities such as purchasing clothes, purchasing home furnishings, paying medical bills, paying a home mortgage, paying home loans, and paying off other debts.

Beginning in 2014 under the Patient Protection and Affordable Care Act (PPACA), those with family incomes up to 138% of the federal poverty level became eligible for Medi-Cal (pursuant to 42 U.S.C. § 1396a(a)(10)(A)(i)(VIII)), and individuals with higher incomes and some small businesses may choose a plan in Covered California, California's health insurance marketplace, with potential government subsidies. Medi-Cal has open enrollment year-round.

Lawful permanent residents (green card holders) are eligible for full-scope Medi-Cal in California regardless of their date of entry if they meet all other eligibility requirements, even if they have been in the United States for less than 5 years. Beginning in 2024, people without a lawful immigration status who meet the requirements for Medi-Cal are eligible for full-scope Medi-Cal. Previously, meeting eligibility requirements other than immigration status qualified them restricted-scope Medi-Cal limited to emergency and pregnancy-related services only unless they qualified for the Young Adult Expansion (YAE) or Older Adult Expansion (OAE), which allowed individuals ages 19–26 or those over the age of 50 full-scope benefits regardless of immigration status.

*Will add under Eligibility after the existing four paragraphs

Application process

There are multiple ways to apply for Medi-Cal: one can apply at a Social Services office or over the phone by calling your nearest social service office, or one can apply online (the most common). Most websites make the application process clear and cohesive. They also allow for the user to select different languages to best navigate the website *add citation*.

However, individuals in need of Medi-Cal often need help with their use of the online application process and face barriers, including

• Rejection of applications due to insufficient explanation
• Repeated requests for additional documentation throughout the application process
• Unclear next steps and transitions in the application process, both for applications submitted directly to Medi-Cal and those initiated through Covered California
• Difficulty accessing support and personalized assistance, including in-language help and resources for Spanish- and Mandarin-speaking applicants
• Challenges in navigating Medi-Cal eligibility and enrollment during significant life transitions, such as aging out of foster care, transitioning off a parent’s health insurance plan, giving birth, getting a divorce, or losing or gaining employer-sponsored insurance.
• Sometimes, individuals don’t have access to the internet or experience confusion.

Online applications seem to pose difficulty for those who aren’t tech-savvy. However, people can apply in-person or over the phone to avoid such confusion.