Medi-Cal is California's version of Medicaid, but with its own rules and coverage

Medi-Cal is California's state Medicaid program. It is the same federal program as Medicaid in other states — it uses federal money and follows federal rules — but California runs it, sets its own income limits, and decides which services it covers beyond what the federal government requires. If you live in California and hear someone mention Medicaid, they are usually talking about Medi-Cal.

The confusion happens because "Medicaid" is the federal program name, and each state operates its own version under that umbrella. Just as Texas Medicaid and New York Medicaid have different rules, Medi-Cal has different rules from Medicaid in other states. When you apply, you apply to Medi-Cal, not to a national Medicaid office.

Key Takeaways

  • Medi-Cal is California's Medicaid program, funded by federal and state money but run by the state with its own income and coverage rules.
  • Income limits for Medi-Cal differ from other states' Medicaid programs because California sets them within federal guidelines.
  • You apply through the California Department of Health Care Services or your county social services office, not through a federal agency.
  • Coverage includes doctor visits, hospital care, prescriptions, and dental and vision care for adults — benefits that vary by state Medicaid program.

How Medi-Cal differs from Medicaid in other states

Each state's Medicaid program has flexibility within federal rules. California chose to expand Medi-Cal to cover more people than the federal minimum requires. For example, California covers adults earning up to 138 percent of the federal poverty level, and it also covers undocumented immigrants in certain age groups — neither of which is required by federal law.

The income thresholds, covered services, and copayments you face in Medi-Cal are specific to California. If you move to another state, you will need to reapply for that state's Medicaid program, and your coverage may change. The same is true in reverse: if you move to California from another state, you cannot transfer your existing Medicaid — you must apply for Medi-Cal.

Who runs Medi-Cal and where to contact them

Medi-Cal is administered by the California Department of Health Care Services at the state level, but you do not apply directly to them. Instead, you apply through your county social services office or online through the California Department of Social Services website. Each county handles applications and renewals for people who live there.

You can also apply through Covered California, the state's health insurance marketplace, if you are looking at both Medi-Cal and private insurance options. Covered California will route you to Medi-Cal if you meet the income limits. The application process is the same regardless of which door you enter — you are applying to the same program.

What Medi-Cal covers that other state Medicaid programs might not

California's Medi-Cal covers more than the federal minimum. All Medi-Cal members receive dental care, vision care, and hearing aids — services that many other states' Medicaid programs do not cover for adults. Medi-Cal also covers acupuncture, chiropractic care, and mental health services more broadly than some neighboring states.

Prescription drug coverage is included, and Medi-Cal covers most medications on its formulary with low or no copayment. The exact copayment depends on your income level and the type of drug. Hospital stays, emergency care, and doctor visits are covered for all members, just as they are in other states' Medicaid programs.

Income limits and may be able to access in California versus other states

Medi-Cal's income limits are set by California and are higher than the federal minimum. As of now, California covers adults up to 138 percent of the federal poverty level, which is roughly $1,900 per month for a single person (this amount changes yearly). Other states set their own limits, and some are lower.

California also covers certain groups that federal law does not require states to cover. Undocumented immigrants under 26 can get Medi-Cal, and so can some people over 65 regardless of immigration status. These expansions are California choices, not federal requirements, so you will not find the same coverage in other states.

How to apply for Medi-Cal in California

You can apply online through the California Department of Social Services website, by mail, in person at your county social services office, or by phone. The online application is the fastest route and you can submit it any time. You will need proof of income, residency, and citizenship or immigration status.

After you submit your application, the county will review it and send you a notice of what they decided. If you are found to meet the income and other requirements, your Medi-Cal coverage begins on the first day of the month you applied or the month after, depending on when the county processes your application. You do not have to wait for a card to arrive to use your coverage — your coverage starts as soon as the county approves it.

Renewing your Medi-Cal coverage

Medi-Cal coverage is not permanent. You must renew it, usually once a year. California will send you a renewal notice before your coverage expires. You can renew online, by mail, or in person. If you do not renew by the deadline, your coverage will end and you will have to reapply.

If your income or household size changes during the year, you can report the change to update your coverage right away. You do not have to wait for the annual renewal. Reporting changes quickly can prevent gaps in coverage or overpayments.

Frequently Asked Questions

Can I use Medi-Cal outside of California?

Medi-Cal is only valid in California. If you travel or move out of state, you will need to use your Medi-Cal in California or apply for that state's Medicaid program if you move. Some emergency services may be covered out of state, but routine care is not.

Is Medi-Cal the same as Medicare?

No. Medi-Cal is for low-income people of any age. Medicare is a federal program for people 65 and older, or younger people with certain disabilities. They are separate programs with different rules and funding sources.

Do I have to pay back Medi-Cal if I get a job and earn more money?

No. Medi-Cal is not a loan. If your income increases and you no longer meet the income limit, your coverage will end at the next renewal, but you will not owe money back for the coverage you received while you were enrolled.

What happens to my Medi-Cal if I move to another state?

Your Medi-Cal ends when you move. You will need to apply for that state's Medicaid program. Some states have higher or lower income limits and different covered services, so your coverage may change.

Can undocumented immigrants get Medi-Cal?

Yes, California covers undocumented immigrants under 26 through Medi-Cal. Some undocumented immigrants over 26 may also be covered depending on other factors. You do not need a Social Security number to apply, though you will need to prove California residency.