Medi-Cal What it Means to You - San Francisco Public Schools

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Table of Contents1. MEDI-CAL – WHAT IT MEANS TO YOU.............................................................................. 12. WHO CAN GET MEDI-CAL?................................................................................................... 13. WHAT DOES IT MEAN TO BE “DISABLED” FOR MEDI-CAL?........................................ 44. HOW MUCH MONEY CAN I GET AND STILL GET MEDI-CAL?................................... 55. WHAT PROPERTY/ASSETS ARE ALLOWABLE FOR MEDI-CAL?................................. 56. MUST I LIVE IN CALIFORNIA TO GET MEDI-CAL?.......................................................... 57. WHERE DO I APPLY FOR MEDI-CAL?................................................................................. 68. HOW DO I APPLY FOR MEDI-CAL?..................................................................................... 69. WHAT DO I NEED FOR VERIFICATION (PROOF)?........................................................... 810. WILL I HAVE A SHARE OF COST AND HOW MUCH WILL IT BE?............................... 911. HOW DO I MEET MY SHARE OF COST?..........................................................................1012. WHAT IF I HAVE PRIVATE HEALTH INSURANCE COVERAGE?...................................1113. WILL MEDI-CAL PAY MY PRIVATE HEALTH INSURANCE PREMIUMS IF ICAN NO LONGER AFFORD TO MAKE PAYMENTS?......................................................1314. WILL I GET A MEDI-CAL IDENTIFICATION CARD?.......................................................1315. WHAT DOES THE BENEFITS IDENTIFICATION CARD (BIC) LOOK LIKE?................1416. WHAT INFORMATION IS ON THE PAPER MEDI-CAL CARD?.....................................1417. HOW DO I USE THE BENEFITS IDENTIFICATION CARD (BIC)?.................................1418. WHAT ADDITIONAL BENEFITS ARE AVAILABLE TO PERSONS UNDER THE CHILDHEALTH AND DISABILITY PREVENTION (CHDP) PROGRAM AND EARLY ANDPERIODIC SCREENING, DIAGNOSIS AND TREATMENT (EPSDT)?...............................1619. WHAT IF I LOSE MY BIC, IT IS STOLEN, OR I DO NOT GET IT?..................................1720. HOW DO I GET MEDI-CAL SERVICES?.............................................................................1721. WILL MEDI-CAL PAY FOR ALL MY MEDICAL/DENTAL EXPENSES?........................1822. HOW CAN I GET HELP FROM MEDI-CAL IF I AM OUT OF STATE?..........................1823. IS MEDI-CAL MANAGED CARE THE SAME AS A HEALTH/DENTALCARE PLAN?.............................................................................................................................1924. CAN I GO TO ANY PROVIDER IF I ENROLL IN A HEALTH/DENTALCARE PLAN?.............................................................................................................................1925. HOW DO I JOIN A MANAGED CARE PLAN?..................................................................1926. HOW DO I GET OUT OF A MANAGED CARE PLAN?...................................................1927. WHAT CAN I DO IF I DISAGREE WITH ANY DECISION ABOUT MYMEDI-CAL ELIGIBILITY OR BENEFITS?.............................................................................2028. WHAT IF I HAVE BEEN HURT BY ANOTHER PERSON OR HURT AT WORK?.................2129. WILL MEDI-CAL BILL A DECEASED MEDI-CAL BENEFICIARY’S ESTATE?.................2130. WHAT IS MEDI-CAL FRAUD?..............................................................................................2231. WHAT DO THE WORDS MEAN?.........................................................................................22SPANISH TRANSLATION OF PAMPHLET...................................................................................25COUNTY WELFARE DEPARTMENTS LISTING..........................................................................55TRADUCCION AL ESPAÑOL DEL FOLLETO............................................ Página 25
1. MEDI-CAL – WHAT IT MEANS TO YOUMEDI-CAL pays for many health care services for certain needy residents ofCalifornia. MEDI-CAL is supported by federal and state taxes. This pamphlettells you how to apply, about benefits, your choices for getting services, howto use the permanent plastic California Benefits Identification Card (BIC) orthe paper MEDI-CAL card, and your appeal rights if you feel you are treatedunfairly or do not get what you are entitled to get by law.You may be eligible for MEDI-CAL benefits regardless of sex, race, religion,color, national origin, sexual orientation, marital status, age, disability, orveteran status.Your local County Welfare Department (CWD) manages MEDI-CAL eligibilitydeterminations. If you have questions, you can find the addresses andtelephone number of the CWD in the back of this pamphlet.The Spanish translation (traduccion al Espanol) follows the English section ofthis pamphlet. A list that explains some MEDI-CAL terms and words is locatedon the back pages of both sections.2. WHO CAN GET MEDI-CAL?Even if you are working, own a house, or are married, you may be eligiblefor MEDI-CAL. To get medical, dental, vision and other covered MEDI-CALservices, you must be eligible under one of the following categories.A. PUBLIC ASSISTANCE (PA): If you are aged (65 years old or older), blind, ordisabled and you get Supplemental Security Income/State SupplementaryPayment programs (SSI/SSP), you are automatically eligible for MEDI-CALand will be sent a California Benefits Identification Card (BIC). Call your SocialSecurity district office for more information.If you get California Work Opportunity and Responsibility to Kids (CalWORKs),you may also be entitled to get MEDI-CAL benefits. If you get other kinds ofPublic Assistance, you may be entitled to all the services covered by MEDI-CAL.Call your county eligibility worker for more information.If you are not in one of these assistance groups, you still may be able to getMEDI-CAL benefits in a different category. Some are listed below, such asMedically Needy (MN) or Medically Indigent (MI). MN and MI programs arefor people who cannot pay all their medical expenses. Even if you have otherprivate health insurance coverage, you may still be eligible.B. MEDICALLY NEEDY (MN): You are Medically Needy if you are age 65 orolder, blind, disabled, or you meet the family circumstances required forCalWORKS (you have children under age 21 who are needy and do not- -
Page 4 and 5: have the support or care of one par
Page 9 and 10: 2. Fill out the application form(s)
Page 11 and 12: 14. All burial trusts/prepaid buria
Page 13 and 14: If any of this information is missi
Page 15 and 16: If you are having a claims payment
Page 17 and 18: Some services are restricted to two
Page 19 and 20: 19. WHAT IF I LOSE MY BIC, IT IS ST
Page 21 and 22: 23. IS MEDI-CAL MANAGED CARE THE SA
Page 23 and 24: 28. WHAT IF I HAVE BEEN HURT BY ANO
Page 25 and 26: 5. INPATIENT HOSPITAL CARE - Care y
Page 27 and 28: MEDI-CALLo Que SignificaPara UstedD
Page 29 and 30: 1. MEDI-CAL - LO QUE SIGNIFICA PARA
Page 31 and 32: • el primer año de vida de su be
Page 33 and 34: NO SE PROPORCIONAN SERVICIOS DE PAT
Page 35 and 36: encima del límite durante todo un
Page 37 and 38: (pruebas)?” Le dice qué pruebas
Page 39 and 40: cuentas, el inventario actual, incl
Page 41 and 42: servicios médicos que usted reciba
Page 43 and 44: • mandarle al Departamento de Ser
Page 45 and 46: 15. WHAT DOES THE BENEFITS IDENTIFI
Page 47 and 48: • Lentes (gafas) y aparatos para
Page 49 and 50: 20. ¿CÓMO OBTENGO SERVICIOS DE ME
Page 51 and 52: 23. ¿ES EL CUIDADO MÉDICO ADMINIS
Page 53 and 54:
preguntas al representante del cond
Page 55 and 56:
3. PLAN PARA EL CUIDADO DE LA SALUD
Page 57 and 58:
State of CaliforniaHealth and Human
Page 59 and 60:
Lake County (17)Department of Socia
Page 61 and 62:
Sacramento County (34)Department of
Page 63 and 64:
Tehama County (52)Department of Soc
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Medi-Cal What it Means to You - San Francisco Public Schools

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