Medi-Cal

As of January 1, 2024, a new law in California extends eligibility for full scope Medi-Cal to people 26 through 49 who meet all Medi-Cal eligibility criteria.

When you have Medi-Cal, the Alliance works with the State of California to help you get the health care you need.

Medi-Cal is California's Medicaid health care program that provides no-cost or low-cost health insurance to Californians. Central California Alliance for Health (the Alliance) is a managed care health plan for people who have Medi-Cal. The Alliance works with the State of California to provide health care to people who live in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties.

The California Department of Health Care Services (DHCS) determines who is eligible for Medi-Cal. You can apply for Medi-Cal benefits regardless of sex, race, religion, color, national origin, sexual orientation, marital status, age, disability or veteran status. If you are eligible, you can get Medi-Cal as long as you continue to meet the eligibility requirements.

You can apply for Medi-Cal at any time of the year.

You may apply online at BenefitsCal or contact your local county office to apply by mail, phone, fax, email or in person:

• Mariposa County Health and Human Services Agency
  Phone: 209-966-200
  800-549-6741
• Merced County Department of Human Services
  Phone: 209-385-3000
• Monterey County Department of Social Services
  Phone: 877-410-8823
• San Benito County Health and Human Services Agency, Public Assistance
  Phone: 831-636-4180
• County of Santa Cruz Human Services Department
  Phone: 888-421-8080

As an Alliance member, you have access to the health care and support services described in the Get Care section of this website.

You will pick one doctor to see for all your health care needs. We call that doctor your Primary Care Provider or PCP. Use the Provider Directory to find a PCP.

Your PCP will provide all of your regular health care. If you need to see any other doctor, your PCP will send a request to the Alliance. This is called a PCP referral. A PCP referral is not needed for emergency care and family planning services. There are some services and medical equipment that must be approved by the Alliance before you can get them. This is called prior authorization. Your PCP or other doctor will send referral and prior authorization requests to the Alliance for approval.

The Alliance covers most health care services provided by your PCP, doctors, hospitals and licensed health care providers in our network. There are some services that are covered by Medi-Cal but not through the Alliance.

For a high-level summary of plan benefits, read the Benefits Matrix.

For full details, read the Member Handbook.

As of July 1, 2022, the Alliance covers community health worker (CHW) services for individuals when recommended by a physician or other licensed practitioner to prevent disease, disability, and other health conditions or their progression; prolong life; and promote physical and mental health and efficiency. Services may include:

• Health education and training, including control and prevention of chronic or infectious diseases; behavioral, perinatal and oral health conditions; and injury prevention.
• Health promotion and coaching, including goal setting and creating action plans to address disease prevention and management.

If you think you may benefit from this service, contact your PCP or call the Alliance Member Services Department.

As of January 1, 2024, a new law in California extends eligibility for full scope Medi-Cal to people 26 through 49 who meet all Medi-Cal eligibility criteria. Californians under the age of 26 or over 49 are already eligible for full Medi-Cal. Immigration status does not matter. This latest expansion of full scope Medi-Cal brings California closer to a Healthy California for All.

If you had active restricted scope Medi-Cal in December 2023, you were automatically transitioned to full scope Medi-Cal. If you received a renewal notice, please fill it out and return it to the county so that there is no processing delay. If you did not have active restricted scope Medi-Cal, you can apply for Medi-Cal online by visiting BenefitsCal.com. If you qualify for full scope Medi-Cal under the ages 26 through 49 Adult Expansion, you will receive a notice to tell you about your eligibility for full scope Medi-Cal and the beginning date, which will be January 1, 2024 or after.

More people can get coverage.

Starting in January 2024, assets will no longer count toward your Medi-Cal eligibility. If your coverage was denied, delayed, reduced or stopped because of your assets, you can ask your local Medi-Cal office to review your case. Learn more on the DHCS website. You can also contact your local county Medi-Cal office if you have questions.

Important: Are you enrolled in Medi-Cal? Has your contact information changed? Give your county office your updated contact information so you can stay enrolled.

As of December 23, 2022, the U.S. government made some changes to the public charge final rule. There are more protections for immigrants and their families to use public benefits without fearing it will affect their immigration status. There are also less barriers for low-income immigrants to get a green card.

The updated public charge rule states that many public benefits will no longer count for public charge, like health care and food. Medi-Cal/Medicaid does not count under the new public charge rule unless someone is:

• In long-term institutionalized care.
• In a skilled nursing home.

Every family is different. It is important to:

• Know your rights.
• Get the facts. Understand if the rule affects you.