Medi-Cal / Low-Income Programs
Medi-Cal is California’s public health insurance program and provides needed health care services for low-income individuals, including families with children, seniors, persons with disabilities, children in foster care, pregnant women, and low-income people with specific diseases such as tuberculosis, breast cancer, or HIV/AIDS. Recipients of CalWORKs and Foster Care are automatically eligible for Medi-Cal.
As a result of the Affordable Care Act, eligibility requirements for Medi-Cal have expanded to include all adults whose annual income is under 138% of the federal poverty level—$16,395 for an individual and $33,534 for a family of four—who are citizens or legal residents. Medi-Cal coverage is free for those who qualify.
Covered California Insurance
If your income is too high to qualify for Medi-Cal, affordable insurance plans are offered through Covered California and you may qualify for tax credits that will help to lower the cost of your insurance premium. When you enroll in a health plan through Covered California, tax credits can be immediately applied to the insurance premium, which reduces the amount you pay each month.
Covered California will make it simple and more affordable for you to get high-quality health insurance that can't be canceled or denied because of a pre-existing medical condition or illness. Purchasing insurance through Covered California will have many advantages. For the first time ever, you will be able to make true "apples-to-apples" comparisons of health insurance. Covered California is the only place where you can learn about and use federal financial assistance that can help lower your health care costs.
SB 75 - Full-Scope Medi-Cal for All Children
Under the new law, SB 75 Full Scope Medi-Cal for All Children, that was implemented in May 2016, children under 19 years of age are eligible for full-scope Medi-Cal benefits regardless of immigration status, as long as they meet all other eligibility requirements (Welfare and Institutions Code section 14007.8.) Ventura County Human Services Agency, Covered California, and other interested parties are working to identify and provide children with full Medi-Cal coverage benefits. See the flyer for 5 Things You Need to Know (5 Puntos Que Necesita Saber Sobre) to enroll your child in full-scope Medi-Cal.
Low-Cost Medi-Cal for Children
Children between the ages of 1 and 19 in families with incomes ranging from 160% to 266% FPL ($38,880 to $64,638 for a family of four) may be eligible for low-cost Medi-Cal insurance. Many of these children were previously enrolled in California’s Healthy Families program and are now eligible for the Low-Cost Medi-Cal for Children program. Monthly premiums are $13 per child with a maximum of $39 per household.
Many long-term care residents may have all or part of their care paid for by Medi-Cal if their income and resources meet Medi-Cal standards. Click here for more information.
250 Percent Working Disabled Program
The 250% Working Disabled Program is a full-scope, zero share-of-cost Medi-Cal program designed for those who are working at least one hour per month with pay and who meet the Social Security Administration federal disability definition. Applicants must meet eligibility requirements, such as California residency, and pay a monthly premium to the Department of Health Care Services (DHCS). After enrollment and payment of the monthly premium, if medical services are covered by Medi-Cal, those services will be paid by the Medi-Cal program. Click here for more information.
Free Health Coverage for Former Foster Youth
If you were in foster care on your 18th birthday, you are eligible for free Medi-Cal benefits until your 26th birthday (regardless of your income). Attached is a quick guide and one page form you can use to sign up and take to any Human Services Intake & Eligibility or Community Services Center. You are encouraged to call Laura Pariseau - (805) 654-3451for assistance.
NEW IRS Form 1095-B
The Affordable Care Act (ACA) requires individuals to have health coverage that satisfies the insurance benefit standards, called Minimum Essential Coverage (MEC). As a result, the Department of Health Care Services (DHCS) sent Internal Revenue Service (IRS) Form 1095-B to all Medi-Cal covered individuals, starting in January 2016. This means you may receive multiple forms if other people in your family are covered under Medi-Cal or Covered California.
The IRS Form 1095-B lists the months of Minimal Essential Medi-Cal Coverage (MEC) received during the calendar year 2015 and is used as proof to report health coverage while filing taxes with the IRS. Learn more about IRS Form 1095-B.
When you apply for CalFresh, Medi-Cal, and other health insurance programs offered through Covered California, you will be asked for information about your residency, identity, citizenship, Social Security number, income, and any other health care coverage you may have. The chart below includes income eligibility information for most health insurance programs as well as CalFresh. You can apply for Medi-Cal, Cal Fresh, and other assistance programs online through My Benefits CalWIN.
|1||$15,444||$16,394||$16,394 - $47,080|
|2||$20,832||$22,107||$22,107 - $63,720|
|3||$26,208||$27,820||$27,820 - $80,360|
|4||$31,596||$33,534||$33,534 - $97,000|
|5||$36,972||$39,247||$39,247 - $113,640|
Health insurance premium assistance is
How to Apply for Medi-Cal
First, use this easy online tool to check your eligibility.
There are several ways to apply for Medi-Cal benefits:
1) Fill out an application online here
Drop it off at a Community Service Center
Mail the completed form to:
County of Ventura
Human Services Agency L#5290
855 Partridge Drive
Ventura, CA 93003-9565
3) Call a Community Service Center to request a paper application, which includes a return postage-paid envelope.
New CalWIN Mobile Application
Have an Android, iPhone, or iPad? For those who do, a mobile application ("app") is now available allowing easy access to:
- Check Your Case Status
- Get Current Benefit Amounts
- Check Your Renewal Dates and Renew CalFresh Benefits
- View Your EBT Balance
The CalWIN Mobile "app" will also help find the nearest Human Services Agency Community Service Center or America's Job Center using GPS or zip code lookup.
Forms & Documents
- Medi-Cal Application - English
- Aplicación de Medi-Cal
- CalFresh & Medi-Cal Application English
- Aplicación en Español para CalFresh y Medi-Cal
- 250 Percent Working Disabled Program Premium Payment Information
- SB 75 - Questions & Answers
- Doctors Accepting Medi-Cal
- Dentists Accepting Denti-Cal
- Vision Care Providers Accepting Medi-Cal - Once you click on the link and create an account, you will receive a list of vision care providers to choose from who accept Medi-Cal
- Pharmacies Accepting Medi-Cal
- Medi-Cal Benefits Frequently Asked Questions
- Long-Term Care Alternatives
- COBRA Information
- Prescription Discount Card
- Helpful Links & Information
- Covered California