What is this service?
Medi-Cal, California's Medicaid program, is a public insurance health care program which provides health care services for low-income individuals and families who meet defined eligibility requirements
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
600 Quintana Road Morro Bay , CA 93442
Tel: (805) 772-6405
Fax: (805) 772-6409
SLO Social Services- Higuera
3433 South Higuera San Luis Obispo, CA 93401
Arroyo Grande Social Services
1086 East Grand Avenue Arroyo Grande, CA 93420
681 West Tefft Street Suite 1 Nipomo, CA 93444
Atascadero Social Services
9415 El Camino Real Atascadero, CA 93422
Paso Robles Social Services
406 Spring Street Paso Robles, CA 93446
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
- 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
Contact Social Services
Child and Adult Hotline Information:
- If you suspect there is an emergency requiring immediate intervention, call 911
- To report suspected child abuse or neglect call the 24 hour Child Abuse Hotline at (805) 781-KIDS (5437) or toll free 1-800-834-KIDS (5437)
- To report suspected elder abuse or neglect call the Adult Services Hotline at (805) 781-1790 during regular business hours, or after business hours call (844) 729-8011