Eligibility
Back to COVID-19 FAQs
1. Will my Medi-Cal end during the COVID-19 public health emergency?
The federal government declared a public health emergency in 2020 due to COVID-19. For most Medi-Cal members, Medi-Cal will not end during the public health emergency. For exceptions, read Question 2 below.
2. When could I lose Medi-Cal during the public health emergency?
Most members will not lose coverage during the public health emergency. However, there are exceptions. Medi-Cal coverage can end if you:
- Die
- Move out of state
- Tell your county Medi-Cal office you no longer want Medi-Cal
- Have Medi-Cal due to an administrative error or fraud
If your Medi-Cal ended for any other reason, call your county to reinstate your Medi-Cal coverage.
3. Do I need to call my local Medi-Cal county office to make sure I keep my Medi-Cal during the public health emergency?
No. The county will send you a Notice of Action if your Medi-Cal eligibility or coverage changes. If your Medi-Cal coverage ends, and that's not what you wanted, please call your county. Also be sure to call your county to report changes that may affect your Medi-Cal eligibility, such as your contact information or if you move to a new county. This will help ensure your coverage stays active and that you get information we send you about your Medi-Cal coverage.
Some county Medi-Cal offices may be closed for in-person services. You can still contact them by phone, mail, email, or online. Your local county office number may be found on the attached list or online at County Office Listings. Or call the Medi-Cal Member Helpline at (800) 541-5555 (TTY (800) 430-7077). If you're outside of California, call (916) 636-1980.
4. What should I do with the Medi-Cal renewal packet I receive in the mail?
Complete the renewal form, gather the requested information, and send the renewal packet back to the county. You will remain eligible for Medi-Cal coverage until the public health emergency ends, even if your renewal is due or you report changes to your personal or household information. You can also turn in information by phone, internet, or a visit to your local county office.
5. What changes do I need to report to my county?
Report any changes, including, but not limited to:
- Contact information (address, phone number, email address, etc.)
- Income
- Who lives with you
- People you claim as tax dependents
You will not lose your eligibility if your report any changes to the county unless you meet an exception listed in FAQ #2 above.
6. How do I report changes to my county?
You can report changes in person, by mail, phone, or online. You may find your local county office number on the attached list or online at http://dhcs.ca.gov/COL.
If you report changes by phone, your county will help you complete the renewal form and sign by phone anything that needs a signature.
If you do not have needed proof of a change, you may give the county a statement by phone or in writing.
7. Do I need to update my contact information with the county?
Yes. Contact your local county office to report changes that may affect your Medi-Cal eligibility, such as your contact information or if you move. This will help ensure your coverage stays active and that you get information we send you about your Medi-Cal coverage.
8. How will my stimulus payments, COVID-19 grants, and recovery rebates affect my Medi-Cal?
Payments you received during the public health emergency will not affect your Medi-Cal eligibility. However, certain Medi-Cal programs have limits on the amount of resources (savings, property, etc.) you can have to be eligible for the program. Saving these payments for more than a year may put you over the resource limit if you are enrolled in a Medi-Cal program that has a resource limit. Ask your county if you are unsure if you are enrolled in a Medi-Cal program that has a resource limit and if your eligibility may be affected.
9. How do my unemployment benefits affect my Medi-Cal eligibility?
Report all unemployment benefits you receive to your local county office. Also, report if your unemployment benefits have ended or will end soon. Some pandemic unemployment benefits do not count as income, so be sure to tell your county worker what kind of unemployment benefits you get/got. If you received Pandemic Unemployment Compensation benefits or Lost Wages Assistance, those unemployment benefits have ended. If you have a family member that has Covered California coverage, you also need to report to Covered California that those benefits have ended
10. Could my Medi-Cal change during the public health emergency?
Yes. You may qualify for a Medi-Cal program with better coverage. You may also qualify for a program that better fits your needs so you don't lose coverage when the public health emergency ends. The county will send you a Medi-Cal Notice of Action if your eligibility or coverage changes. Contact your local county welfare office if you have questions about your coverage.
11. Could my share of cost (SOC) go up during the public health emergency?
Your share of cost or premium should not increase during the public health emergency if you are living in the community. If your share of cost goes up, call your county.
You may be granted a Medi-Cal program with a share of cost if you move into a long-term care facility. You may also receive an increase in share of cost while living in a long-term care facility.
You will receive a Notice of Action if your eligibility were to change and you now have a share of cost. You may ask for a hearing if you disagree with the Notice of Action you receive.
12. What if I cannot pay my Medi-Cal premium?
If you cannot pay your Medi-Cal premium during the public health emergency, you can call the county to get your premium waived (dismissed). You will not have to pay back any waived premiums. You can also ask for credits for premiums you already paid during the public health emergency.
If you are leaving a Medi-Cal premium program, you can ask for a refund of the premiums that you paid in advance or paid in excess of what you owe.
Tell the county if your income has gone down. You may qualify for free Medi-Cal.
For questions about premiums, call the below Medi-Cal program phone numbers:
- Children and pregnancy programs: (800) 880-5305
- Medi-Cal Access Program: (800) 433-2611
- County Children's Health Initiative: (833) 912-2447
All call centers are open Monday through Friday, 8 a.m. to 7 p.m., and Saturday, 8 a.m. to 12 p.m. All have TTY/TTD and language services. For the 250 Percent Working Disabled Program, there are three ways to ask for a premium waiver:- Call (916) 445-9891, Monday through Friday, 8 a.m. to 12 p.m. and 1 p.m. to 5 p.m. You can ask for help in other languages.
- Fax your request to (916) 440-5676
- Fill out the online inquiry form at Inquiry form
13. What are my appeal rights if I disagree with a county action regarding my Medi-Cal coverage?
You have the right to ask for a fair hearing regarding your Medi-Cal coverage. The county is required to send you a Notice of Action when there is a change in your Medi-Cal benefits. During the public health emergency, you have 210 days from the date you receive the county's Notice of Action to ask for a hearing.
You will keep your Medi-Cal during your appeal. Even if the hearing decides that your Medi-Cal should end, you will keep your benefits until the public health emergency ends.
To ask for a hearing, fill out the "Request for State Hearing" form on the back of the Notice of Action. Be sure to provide all requested information, including your full name, address, telephone number, the name of the county that took the action against you, the aid programs involved, and the reason you are requesting a hearing.
If you do not understand English, please tell us your preferred language. Language help will be available to you at the hearing for free. If you have an authorized representative, tell us their name and address so we can share important information about your case with them. You may also send us a letter to tell us why you think the county decision is wrong. Keep a copy of your hearing request.
You may send in your hearing request in one of these five ways:
- Mail it to the county welfare department at the address shown on the Notice of Action
- Or Mail it to:
California Department of Social Services
State Hearings Division
P.O. Box 944243, Mail Station 21-37
Sacramento, California 94244-2430 - Fax it to the State Hearings Division at (833) 281-0905
- Submit it online at the California Department of Social Services (DSS) hearing request page: Hearing Request
- Call the DSS Public Inquiry and Response toll-free line at (800) 743-8525 / (TDD: (800) 952-8349)
To learn more about Medi-Cal fair hearings, you may also go to: DHCS Website (fair hearings)
