FAQs

Medi-Cal is a California public health program that offers free or low-cost health coverage to California residents who  qualify. California has been expanding Medi-Cal to a larger and more diverse group of people. Starting January 1, 2024, immigration status will not matter for any Medi-Cal applicant in California.

What is free or low-cost health coverage?
People who qualify for Medi-Cal will have no or low monthly premiums, no copays, and no out-of-pocket costs for most covered services.

To qualify for Medi-Cal, you must meet certain requirements. For instance, you must have a certain income based on the Federal Poverty Level Guidelines.

We can help you find out if you may qualify for Medi-Cal. Enter your zip code and select your county. Then provide your household size and income to find out if Medi-Cal may be an option for you and/or your children.

You must qualify for Medi-Cal and live in a county where Kaiser Permanente provides Medi-Cal Managed Care services. You must also meet one of these criteria:

1. You were a prior Kaiser Permanente member in the last twelve (12) months
OR
2. You are a qualified immediate family member of a current Kaiser Permanente member

NOTE: If you are currently in foster care or a former foster youth, or a Medicare beneficiary (and your Medicare is already assigned to Kaiser Permanente), you do not need to meet the above criteria.

What is an immediate family member?
An immediate family member is one of these:

• Spouse or domestic partner
• Dependent child under 26 years of age
• Stepchild under 26 years of age
• Disabled dependent over 21 years of age
• Parent or stepparent of a beneficiary under 26 years of age
• Grandparent, guardian, foster parent, or other relative of a beneficiary under 26 years of age with appropriate documentation of familial relationship

You can apply for Medi-Cal at https://benefitscal.com/. Or, you can apply by phone or in person at your nearest Local County Services Office.

You can apply any time during the year – there is no deadline to enroll in Medi-Cal.

If you applied through Covered California, contact Covered California at 1-800-300-1506. If you applied through the county, contact the Local County Services Office where you applied. Once your county decides you qualify for Medi-Cal, you’ll get a Medi-Cal ID card called a Benefit ID Card (BIC) from the county. Once you receive your BIC you can start using your Medi-Cal benefits.

You may then need to provide more information to enroll into a Medi-Cal Managed Care plan.

If the county decides that you don’t qualify for Medi-Cal, your file will be sent to Covered California to be reviewed for financial help through Covered California. You will receive more information about what your next steps are. You do not need to fill out another Covered California application.

To check on your transition status, call Covered California at 1-800-300-1506.

Yes, families with higher incomes may find that only their children qualify for Medi-Cal while the parents qualify to receive financial help on a Covered California health plan.

Please contact your Local County Services Office or call Covered California at 1-800-300-1506 for more information. If you already filled out an application for Medi-Cal, you will not have to fill out another one for help through Covered California.

Individuals who qualify for Medi-Cal will have no or low monthly premiums, no copays, and no out-of-pocket costs for most covered services.

Medi-Cal and Covered California both offer health coverage. The most income a person or family can have to qualify for Medi-Cal is lower than for Covered California health plans. If you qualify for Medi-Cal, most of your health care will be free or low-cost to you and your family members who qualify.

Families with higher incomes may find that their children qualify for Medi-Cal while the parents qualify to receive financial help on a Covered California health plan.

Yes, you can choose your own primary care doctor from our wide network of doctors. You can also switch to a new Kaiser Permanente doctor at any time.

All of our available doctors take our Medi-Cal members. Simply visit kp.org/chooseyourdoctor.

You can find information on medical facility locations, departments, and care on kp.org. You can also call Member Services, 24 hours a day, 7 days per week at:

• 1-800-464-4000 (toll free) or 711 (TTY)
• 1-800-788-0616 (español)
• 1-800-757-7585 (Chinese dialects)

Your Member Handbook contains the Evidence of Coverage, which gives you complete benefit information.

Prescription drugs are covered by the Medi-Cal Rx program. The Medi-Cal Contract Drug List describes what drugs are covered. You can get more information from Medi-Cal Rx at 1-800-977-2273 (TTY 711), 24 hours a day, 7 days a week.

To speak with someone in the pharmacy who can help you transfer your prescription(s), call Member Services.

• 1-800-464-4000 (toll free) or 711 (TTY)
• 1-800-788-0616 (español)
• 1-800-757-7585 (Chinese dialects)

When you call, please have these things ready:

• your prescription number(s)
• the name and phone number of the pharmacy where you wish to transfer them from 

We’ll handle the rest. You can also visit New Member Prescription Transfer for information on how to transfer your prescriptions.

Yes, be sure to bring your BIC with you to your appointments before and after you receive your Kaiser Permanente ID card.

Your Medi-Cal benefits will stay active for 1 year if you have no change in circumstances (such as income, moving, adding family member, divorce). Every year, your county will check if you still qualify before your Medi-Cal benefits can be renewed. Learn more about the annual renewal process.

Yes, if the county decides that you or your family no longer qualify for Medi-Cal, your file will be sent to Covered California to be reviewed for financial help through Covered California. If so,  you may be able to stay with Kaiser Permanente. You will receive more information about what your next steps are. You do not need to fill out another Covered California application.