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Health Coverage for Families with Children

Last modified: 4/23/2013 1:18 PM

The Medi-Cal Program 

24-Hr Automated InfoLine: 1-877-96-BENEFITS or 1-877-962-3633

The Medi-Cal program provides free health care coverage to certain low-income families with children under 18 years of age through the Section 1931(b) Program.
 
Families who don’t qualify under this program may be eligible for other Medi-Cal programs with a share of cost (similar to a monthly deductible).
 
The eligibility information listed below will give you an idea of whether you may be eligible to receive Medi-Cal coverage under Section 1931(b). However, eligibility for Medi-Cal can only be fully evaluated by an Eligibility Worker (EW) at one of the Social Services Agency Intake Offices. If and when you decide to apply, your EW will explain in further detail what requirements specifically apply to your situation.
 
Basic Eligibility Requirements

To be eligible for Medi-Cal under Section 1931(b), families with children must be in one of the following groups:

 

  • CalWORKs Recipient. (Note: Families with children in this category automatically receive Medi-Cal coverage.)
  • Families eligible for CalWORKs but who do not want to apply for CalWORKs.
  • Persons/families being discontinued from CalWORKs (in most cases).
  • Families who meet the more liberal income and property requirements of the non-cash-based Section 1931(b) Program. (See chart below)
Families must also meet the following requirements:
 

  • Children must be deprived of parental support because one of the parents is deceased, incapacitated, unemployed, or absent from the home.
  • Any money the family currently has available to meet their needs is counted as income.  Income includes but is not limited to: Job earnings, Unemployment Insurance Benefits, Disability Benefits, Social Security Benefits, and so on. The net income amount must be less than the amount shown on the Maximum Aid Payable (MAP) Chart for the family size.

The family’s income and property must be within the program’s limits. (See chart below)

 

Section 1931(b) Income & Property Limits Chart

 
Number of Persons Income Income Limits
(Effective 4/1/12 - 3/31/13)
Income at or below:
Property Limit
1 $ 958 $ 2,000
2 1,293 3,000
3 1,628 3,150
4 1,963 3,300
5 2,298 3,450
6 2,633 3,600
7 2,968 3,750
8 3,303 3,900
9 3,638 4,050
10 3,973 4,200 for 10 or more persons
For each additional person add: 335 N/A
 

Children must be under 18 years of age. (Note: Children age 18 to 21 may still be eligible under other Medi-Cal programs.)

  • Custodial parents must cooperate with the Local Child Support Agency when there is an absent parent. If parents do not cooperate with the child support agency requirements, only the parents will be ineligible for Medi-Cal; children remain eligible.

Applying for Medi-Cal

If you would like to apply for Medi-Cal health coverage under Section 1931(b) you may:

  • Apply in person by going to one of the Social Services Agency Intake Offices and filling out an application, or
  • Call an Intake Office and ask for a mail-in Medi-Cal application.
  • Apply online via the Benefits CalWIN website at http://www.mybenefitscalwin.org . Your worker will review your online application and contact you by phone or mail if additional information is needed.

You may also call one of the intake offices and ask to speak with the Information Supervisor. The Information Supervisor will answer any questions you may have about Medi-Cal.

Documents You Will Need to Bring When You Apply

Your Eligibility Worker (EW) will tell you exactly what documents you will need to provide as proof of identity, income, property, residence, and so on.  The following list contains examples of some of the most common items you may need to provide so that your EW can see if you are eligible for Medi-Cal benefits. 

   Proof of Identity 

  • California Driver’s License or ID from the Department of Motor Vehicles (DMV) 
  • Passport

   Proof of Social Security Number 

  • Social Security Card 
  • Proof of application for Social Security Card 

   Proof of Immigration Status 

  • Permanent Resident Card/Green Card/ Alien Registration Card

   Proof of Property 

  • Bank statements (checking and/or savings accounts) 
  • Car registrations 
  • Papers that show the value of property 

   Proof of Income 

  • Pay stub or employer’s documents 
  • Other papers that provide proof of monthly income (e.g., Social Security Award Letter, Unemployment check stub, and/or Disability check stub)

   California Residency 

  • Housing bill/receipt 
  • Utility bill