Viewing FAQs for Medi-Cal
Medi-Cal is California's Medicaid program. Medi-Cal provides(link is external) free or low-cost medical, vision, and dental services(link is external) for individuals and families who live in California and meet all eligibility criteria. People who receive Medi-Cal in Marin include low-income adults, families with children, seniors, persons with disabilities, children in foster care, former foster youth up to age 26, pregnant persons, etc. For more information, click here for English and here for Spanish.
The County Medical Services Program (CMSP) provides temporary health coverage for uninsured low-income, indigent adults that are not otherwise eligible for other publicly funded health care programs.
CMSP is generally available to individuals who meet the following eligibility criteria:
- Are a resident of Marin County
- Are between the ages of 21 through 64
- Have income between 138% and 300% of the Federal Poverty Level
- Meet personal property limits.
For more information about CMSP eligibility, click here for English and here for Spanish.
For more information about what services CMSP provides, click here for English and here for Spanish.
If you get SSI, do not have a U.S. mailing address, and are unable to change your address online, you can report your change by:
- Calling (800)7 72-1213 (TTY (800) 325-0778), Monday through Friday, 8 a.m. – 7 p.m.
- Contacting your local Social Security office via their online locator (link to external site).
If you get SSI, Social Security will process your Medi-Cal renewal. If you have questions, call (800) 772-1213, or contact your local Social Security office.
There are generally two kinda of Medi-Cal coverages: full scope and restricted scope:
- Full scope benefits generally provides medical, dental, mental health, vision (eye) care, drugs your doctor orders, and more. Full scope Medi-Cal and CMSP benefits are available to individuals who meet all eligibility criteria and are either United States citizens/nationals or have satisfactory immigration status.
- Restricted scope benefits provide limited health care coverage such as emergency services and pregnancy-related services. Restricted scope Medi-Cal and CMSP benefits are available to individuals who meet the eligibility criteria and whose immigration status has not been determined, who are not United States citizens/nationals, or who do not have satisfactory immigration status.
Important things to note about full scope coverage and restricted scope coverage:
- Effective May 1, 2016, all children under the age of 19 are eligible for full-scope Medi-Cal benefits regardless of immigration status, as long as they meet all other eligibility requirements.
- Effective January 1, 2020, under the Young Adult Expansion policy change, all young adults under the age of 26 are eligible for full scope Medi-Cal benefits regardless of immigration status, as long as they meet all other eligibility requirements.
- Effective May 1, 2022, under the Older Adult Expansion policy change, all adults age 50 and older are eligible for full scope Medi-Cal benefits regardless of immigration status, as long as they meet all other eligibility requirements.
- Effective January 1, 2024, under the Adult Expansioni policy change, all adults age 26 through 49 years of age are eligible for full socpe Medi-Cal benefits regardless of immigration status, as long as they meet all other eligibility requirements.
There are multiple convenient ways you can apply for Medi-Cal and CMSP, including:
- Online: www.benefitscal.com(link is external) or www.coveredca.com(link is external)
- By Phone: (877) 410-8817
- In person:
- 120 N. Redwood Drive, San Rafael, CA 94903
- 3240 Kerner Blvd., San Rafael, CA 94901
- 1 6th St., Point Reyes Station, CA 94956
- By fax: (415) 473-355
- By mail: PO Box 4160, San Rafael, CA 94913
Anyone can apply at any time of the year. There is no limit to how many times you can apply for Medi-Cal or CMSP and there is no cost to apply for either of these programs.
You will need to provide an application and may be asked to provide additional information or documentation, including, but not limited to:
- Proof of income such as pay stubs, Social Security award letter, child support or alimony, unemployment/disability stubs, or veterans benefits
- Proof of identification, citizenship and/or immigration status
- Proof of resources such as checking and savings account statements, stocks, bonds, annuities, vehicle registration, life insurance, etc.
Once you submit your application, it will be reviewed by an Eligibility Worker. If additional information or documentation is needed, the Eligibility Worker will contact you to request the information. You can provide information by mail, by phone, in person, by fax, and in some cases, by email.
After your application has been reviewed and processed, you will receive a Notice of Action detailing what you are eligible for. If you are eligible for Medi-Cal or CMSP, you will receive a Benefit Identification Card (BIC) shortly after your approval. You can use your BIC at participating doctor's office, pharmacies, etc. If you did not receive a BIC card or need a replacement card, please reach out to our Call Center at (877) 410-8817 to speak with an Eligibility Worker.
If you are not eligible for Medi-Cal or CMSP, you may be referred to Covered California to explore other health and dental insurance options.
You will get a letter in the mail. The letter will tell you if your Medi-Cal coverage was renewed automatically or if your county needs more information to renew your Medi-Cal. If you receive a renewal packet or a letter asking for more information, you may submit the information by mail, phone, in person, or online. Counties will mail you a letter about your Medi-Cal eligibility. You may need to complete a renewal form. The letter from your county should arrive around the same time as when you have received similar letters in past years. For example, if your Medi-Cal renewal was due in April in past years, you should watch for a letter from your county in the two months before April.
Partnership Health Plan (PHP) is the managed care provider for Marin County. PHP helps Medi-Cal beneficiaries find a doctor and use their Medi-Cal services. Most newly eligible Medi-Cal beneficiaries will receive information from PHP within 30 days of their Medi-Cal approval.
Individuals and families who meet all Medi-Cal eligibility criteria may be eligible for one of the following types of Medi-Cal:
- Zero share of cost (free) Medi-Cal, or
- Medi-Cal with a share of cost
Note: whether or not you have free Medi-Cal or Medi-Cal with a share of cost depends on many factors including but not limited to household composition, household income, household expenses, and tax filing status.
If you no longer qualify for Medi-Cal, you may be able to get health coverage through Covered California. Losing Medi-Cal allows you to enroll in a Covered California plan outside of the open enrollment period. The local county office will send you information about how to sign up.
You may soon need to take steps to find out if you still qualify for Medi-Cal. Counties will mail you a letter about your Medi-Cal eligibility. You may need to complete a renewal form. Make sure your current contact information is updated with your local county office, if it has changed.
The local county office will only ask you for more information if they need it to renew your Medi-Cal. If you receive a renewal packet or a letter asking for more information, you may submit the information by mail, phone, in person, or online.
If you moved recently, or if any of your contact information, like your phone number or email address, has changed, report your changes to your local county office to make sure you get important information about your Medi-Cal coverage. If you got a new job or your income has changed, be prepared to provide verifications. Check your mail – Counties will mail you a letter about your Medi-Cal eligibility. You may need to complete a renewal form. If you're sent a renewal form, submit your information by mail, phone, in-person, or online, so you don't lose your coverage. Create or check your online account – Covered California, BenefitsCal, or MyBenefitsCalWIN to sign up to get text or email alerts about your case. You may submit renewals or requested information online.
You can find more information about current Public Charge rules on the Marin HHS Public Charge website and the Canal Alliance Public Charge website.
You can find for a dentist that accepts Medi-Cal by visiting the Medi-Cal Dental Portal website and searching for a dentist near you.
BenefitsCal.com is a new simple way for customers to apply for, view, and renew benefits for health coverage, food and cash assistance.
BenefitsCal is the first statewide automated site built by and for the people of California. Together, we benefit.
BenefitsCal will make it easier than ever to:
- Apply online
- Renew your benefits
- Upload documents
- Report changes
- Connect with a caseworker
BenefitsCal supports applications for
- Medi-Cal/County Medical Services Program (CMSP)
- General Aid/General Relief (GA/GR)
- Disaster CalFresh
- Cash Assistance Program for Immigrants (CAPI)
Visit BenefitsCal.com today to apply!