Medi-Cal

Who can use this service?

Medi-Cal is available to low income families, children, pregnant women, childless adults and aged and disabled adults.

Is there a charge for this service?

While many Medi-Cal programs do not have a cost, others have premiums and share of cost amounts. These amounts vary depending on the program eligible to, the countable income and household size. These amounts can also be different for different individuals in the household.

What is the process?

Step 1: Application for Medi-Cal

[Applications for programs can be done by phone, fax, online, and in person at any of the six Department of Social Service Offices or online at www.coveredca.com or www.mybenefitscalwin.org.  Offices are open 8-5 Monday – Friday excluding holidays

Step 2: Verification of Information

Once a Medi-Cal Application is received the information verified, that information is then compared to the criteria of the many different Medi-Cal programs available.

Step 3: Notification of Approval/Denial

Results of approval or denial of a Medi-Cal application will be sent in writing.

Step 4: Approval of Medi-Cal Application

If eligible you will have a case manager assigned, there will be instructions included on how to use these services and a managed care company that will assist you with choosing a primary care physician. 

When and where is this service offered?

Applications for programs can be done by phone, fax, online, and in person at any of the six Department of Social Service Offices or online at www.coveredca.com or www.mybenefitscalwin.org.  Offices are open 8-5 Monday – Friday excluding holidays

Location, directions and hours of operation

Click on location name to show hours of operation, directions and phone information

Morro Bay Social Services

Monday - Friday 8-5

600 Quintana Road Morro Bay , CA 93442

Tel: (805) 772-6405

Fax: (805) 772-6409

SLO Social Services- Higuera

Monday - Friday 8-5

3433 South Higuera San Luis Obispo, CA 93401

Tel: (805) 781-1600

Arroyo Grande Social Services

Monday - Friday 8-5

1086 East Grand Avenue Arroyo Grande, CA 93420

Tel: (805) 474-2000

Nipomo Social Services

Monday - Friday 8-5

681 West Tefft Street Suite 1 Nipomo, CA 93444

Tel: (805) 931-1800

Atascadero Social Services

Monday - Friday 8-5

9415 El Camino Real Atascadero, CA 93422

Tel: (805) 461-6000

Paso Robles Social Services

Monday - Friday 8-5

406 Spring Street Paso Robles, CA 93446

Tel: (805) 237-3110

Frequently Asked Questions

Are there property limits/asset tests for all Medi-Cal Programs?

No, only some programs required property limits/asset tests for Medi-Cal Programs. 

Is there retroactive eligibility to Medi-Cal?

Yes, Medi-Cal allows three (3) months of potential retroactive eligibility, if there are medical expenses in those months, and eligibility to the program exists. An application for retroactive coverage must be submitted within one year of the month for which retroactive coverage is requested.

What is the premium cost for children?

For children's Medi-Cal programs that have a premium, the premium is $13 per child up to three (3) children, a maximum of $39 per household. Households with more than 3 children in a premium program still only pay $39.

What does Medi-Cal cover?

Medi-Cal can be used for allowable medical services with providers who accept it. Providers can include hospitals, physicians, pharmacies and durable medical equipment. The following may be covered:
 

  • Outpatient (ambulatory) services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Programs such as physical and occupational therapy (known as rehabilitative and habilitative services) and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Children’s services, including oral and vision care