San Diegans for Healthcare Coverage, A Coalition for Health

Medi-Cal Eligibility for Low Income Adults

The goal of the Affordable Care Act (ACA) is to provide all Americans with affordable health insurance. Beginning January 2014, Medicaid (called Medi-Cal in California) will be available to an additional one to two million low-income adults in California who were previously ineligible.

At a Glance

Historically, Medi-Cal has only covered low-income individuals with specific linkages, such as having children, being aged or disabled, pregnant or diagnosed with other specific conditions.  On January 1, 2014, Medi-Cal will become available to low-income adults previously not eligible for the program.

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What is Medi-Cal and Who is Eligible?

What is Medi-Cal?

Medi-Cal is a public health insurance program that provides healthcare services to qualified low-income individuals. Medi-Cal is California’s Medicaid program and is funded by both State and federal government dollars.

Who is Eligible for Medi-Cal today?

The following persons may be eligible:

  • Children under 21 years of age
  • Persons 65 years of age and older
  • Disabled and blind persons
  • Pregnant women
  • Women who have been screened for breast and/or cervical cancer
  • Families where at least one child is under 21 and at least one parent is absent, disabled, unemployed or working (depending on hours worked and income earned)
  • Anyone who is eligible for CalWORKS; Supplemental Security Income and State Supplemental Program (SSI/SSP); Entrant or Refugee Cash Assistance (ECA or RCA); or In-Home Supportive Services (IHSS); Foster Care or Adoption Assistance Program.

Other individuals may also qualify but may have to pay a share of their medical expenses each month (share-of-cost) before coverage begins. See the Coverage Today section of the site for more information.

Who Will be Eligible in 2014?

Who is Eligible for Medi-Cal Beginning January 2014?

Medi-Cal services will be expanded beginning January 2014. In addition to the individuals who satisfy the eligibility requirements listed above, Medi-Cal will also be available to adults under 138% of the federal poverty level who are citizens or legal California residents for 5 or more years.  For example, under 2011 FPL levels, a single individual making less than $1252 per month, or a couple making less than $1,691 per month, would be eligible.  If your income is close to these levels, you should still apply because some income may not count. More information is available in the Help Paying for Coverage section.

Am I Eligible for Medi-Cal?

How do I Determine if I am Eligible for Medi-Cal?

The Benefits Calwin website provides an easy way for you to learn about and apply for food and/or medical assistance in order to stay healthy. The tool to determine Medi-Cal eligibility is found at Medi-Cal Eligibility.

You can also apply for Medi-Cal at the nearest San Diego County District Office. To locate the District office closest to you call 866-262-9881 or go to the County of San Diego website for Medi-Cal.

Additional Resources

Additional Resources

To find information about other public programs, go to the section on this website entitled Public Program Coverage Options

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