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Frequently Asked Questions

Published on: 4/25/2017 5:25 PM
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How can I apply for Medi-Cal?

Who is eligible to Medi-Cal?

How long does the Medi-Cal application process take?

I have medical bills due from past months. Can I apply for Medi-Cal for those months?

I am leaving the State for awhile. What will happen to my Medi-Cal?

I am a minor (under 21) living with my parents. Can I apply for Medi-Cal?

What are my options if I don’t qualify for Medi-Cal?

What can I do if I don’t agree with the County’s decision?

Is it possible for members of the same family to qualify for different coverage at the same time?

How can I apply for Medi-Cal?

There are several ways to apply:

  • Apply online at www.benefitscalwin.org or download the My Benefits CalWIN app on your cell phone
  • Print the Medi-Cal Mail-In Application from the State website and either mail to one of the district offices (see below) or fax to 408-295-3600
  • Call 408-758-3600 to have an application mailed to you
  • Apply in person at any district office
Office   Address
Assistance Application Center (AAC) 1867 Senter Road San Jose, CA 95110
South County District Office 379 Tomkins Court Gilroy, CA 95020
North County District Office 1330 West Middlefield Road Mountain View, CA 94043

Who is eligible to Medi-Cal?

With the implementation of the Affordable Care Act, everyone is potentially eligible to Medi-Cal. You are encouraged to apply and a County Eligibility Worker will review your program eligibility.

How long does the Medi-Cal application process take?

Medi-Cal applications can take up to 45 days to process.

I have medical bills due from past months. Can I apply for Medi-Cal for those months?

Yes. You can apply for coverage in any of the three months prior to the month of application.

  • Example: If you apply in April of 2016, you can get Medi-Cal in January, February, and March of 2016.

I am leaving the state for awhile. What will happen to my Medi-Cal?

If you remain a resident of California, you can continue to receive Medi-Cal benefits. If you plan on leaving California for more than 30 days, contact your county worker. Not all services are covered out of state and not all providers accept Medi-Cal. Ask the out of state provider before receiving services.

I am a minor (under 21) living with my parents. Can I apply for Medi-Cal?

You may apply for yourself if you file your own taxes and your parents do not claim you as a tax dependent.

If you are living with your parents and they do claim you as a tax dependent, you may apply for confidential Minor Consent benefits without parental consent.

What if I don’t qualify for Medi-Cal, what are my options?

All lawfully present individuals who are over the income limit for Medi-Cal will automatically be evaluated for coverage through Covered CA and will be contacted in regards to choosing a plan.

Individuals who are between 21 and 64 years of age and don’t qualify for Medi-Cal may be eligible for the Ability to Pay Program Determination (APD) at Valley Medical Center.

If I don’t agree with the County’s decision, what can I do?

The back of every Notice of Action sent by the county has contact information and an explanation of your rights and how to ask for a hearing. You have 90 days from when the county mailed the Notice of Action to ask for a hearing.

Is it possible for members of the same family to qualify for different coverage at the same time?

Yes. It is common for members of the same tax household to qualify for different plans. For example, both parents could be eligible for tax credits through Covered California while the children are eligible for Medi-Cal. This is because the eligibility rules are different between programs and age groups. Your County Eligibility Worker will determine which plan is appropriate for each household member.

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