Medi-Cal

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 Covered California, or contact your local county office to apply by mail, phone, fax, email or in person:

• Merced County Department of Human Services
  Phone: 209-385-3000 or 855-421-6770
• Monterey County Department of Social Services
  Phone: 877-410-8823
• 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 May 1, 2022, the Older Adult Expansion extends eligibility for full scope Medi-Cal to people 50 years of age or older who meet all Medi-Cal eligibility criteria. Immigration status does not matter.

If you had active restricted scope Medi-Cal in May 2022, 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 mail, by telephone, at your local county office, by fax or in person. If you qualify for full scope Medi-Cal under the Older 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 May 1, 2022, or after.

On July 1, 2022, the asset limit increased for Medi-Cal programs for people who are 65 or older or disabled. These changes apply to things you own that can be counted for Medi-Cal eligibility. These items include bank accounts, cash, second vehicles and homes, and other financial resources. The previous limits were $2,000 for one person, and $3,000 for a couple. The new limits are $130,000 for one person, and an additional $65,000 for each additional family member.

If you believe you may be eligible for Medi-Cal because of the increase to asset limits, you are encouraged to apply. If you are already in a Medi-Cal program that has asset limits, you will be able to keep more than you could before. Please contact your local county Medi-Cal office if you have any questions.

Questions?

If you have any questions, or if your Medi-Cal application was denied, please contact your local county office.

• Merced County
  Merced County Human Services Agency
  2115 West Wardrobe Avenue, Merced, CA 95341
  855-421-6770 or 209-385-3000
  www.co.merced.ca.us/458/Medi-Cal
• Monterey County
  Monterey County Department of Social Services
  1000 South Main Street, Salinas, CA 93901
  Current Medi-Cal members: 877-410-8823
  New applicants to Medi-Cal: 866-323-1953
  www.co.monterey.ca.us/government/departments-i-z/social-services
• Santa Cruz County
  County of Santa Cruz Human Services Department
  1020 Emeline Ave., Santa Cruz, CA 95060
  18 W. Beach Street, Watsonville, CA 95076
  888-421-8080
  www.santacruzhumanservices.org

Check in with the Alliance. Check in with your county. Make sure you’re covered! 

Visit our Update your Medi-Cal page for details.

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.

For more information on public charge, visit our website at www.thealliance.health/health-plan/medi-cal/public-charge.