County of Marin Health and Human Services

What is the difference between full scope and restricted scope benefits?

Answer: 

  • 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.
  • 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.