Medi-Cal is the Medicaid program in California. It provides health coverage to people with low income and asset levels who meet certain eligibility requirements. If you live in the County of Los Angeles, California, and need help with Medi-Cal, we can help. In this post, we will review everything you need to know about Medi-Cal in Los Angeles County – including who is eligible for Medi-Cal, Medi-Cal income limits, how to apply for benefits, Department of Public Social Services (DPSS) contact information, and Medi-Cal providers in Los Angeles County, including L. A. Care Health Plan.
Before we get into Medi-Cal eligibility guidelines, first, we will explain what Medi-Cal is about and California’s Medicaid expansion.
Next, we will explain the Medi-Cal eligibility guidelines in detail, including the income limit, which is the most important.
We will then walk you through the 3 ways you can apply for Medi-Cal in Los Angeles County.
Additionally, we will provide DPSS contact information, including the phone number and hours of operation.
Lastly, we will answer the most frequently asked questions about Medi-Cal in Los Angeles County, including what Medi-Cal covers.
Table of Contents:
Medi-Cal is California’s Medicaid public health insurance program. Medi-Cal provides free or low-cost medical services for children and adults with limited income (and limited resources for some Medi-Cal programs).
The program is supported by federal and state taxes.
Effective January 1, 2014, the Affordable Care Act (ACA) expanded Medi-Cal coverage to previously ineligible adults (childless, non-disabled, non-elderly).
Medi-Cal Program and Services include:
In Los Angeles County, the Medi-Cal program is managed by the Department of Public Social Services (DPSS).
In addition to Medi-Cal benefits, the DPSS also handles CalFresh, CalWORKs, and General Relief applications and benefits.
Furthermore, BenefitsCal is the website for Los Angeles County Residents to apply for and to view their benefits online.
Continue reading below for BenefitsCal account information.
The video below from the LA DPSS does a great job of summarizing the Medi-Cal benefits and specifically, Medi-Cal in LA County.
Effective January 1, 2014, The Affordable Care Act (ACA) expanded Medicaid benefits to low-income, childless adults between the ages of 19-64 who meet the low or no income requirements.
Also, starting on January 1, 2020, a new law in California gave full-scope Medi-Cal to young adults under the age of 26, and immigration status does not matter.
This is referred to as the Young Adult Expansion. All other Medi-Cal eligibility rules, including income limits, will still apply.
Furthermore, beginning May 1, 2022, a new law in California will give full-scope Medi-Cal to adults 50 years of age or older and immigration status does not matter.
This is referred to as the Older Adult Expansion. All other Medi-Cal eligibility rules, including income limits, will still apply to this new group.
There are three ways you can qualify for Medi-Cal:
First, you can qualify if you meet the income limits.
To see if you qualify based on income, look at the chart below. Income numbers are based on your annual or yearly earnings.
Second, you can also get Medi-Cal if you are:
Third, if you are enrolled in one of the following programs, you can also get Medi-Cal:
The Los Angeles County Medi-Cal income limit follows the California Medi-Cal Income Limit and is calculated as a percentage of the Federal Poverty Line (FPL).
To be eligible for Medi-Cal, you cannot make more than the income guidelines outlined below:
Below are the California Medi-Cal income limit charts, one showing eligibility for children and the other showing eligibility for adults.
First is the income limit for children by age category.
Find the age category your child falls into and you will see the income limit by household size.
| ">California Medicaid Income Limit – Children | ||||||
| ">Children Medicaid Ages 0-1 | ">Children Medicaid Ages 1-5 | ">Children Medicaid Ages 6-18 | ">Children Separate CHIP | |||
| ">% FPL | " data-sheets-numberformat="">100% | " data-sheets-numberformat="">266% | " data-sheets-numberformat="">266% | " data-sheets-numberformat="">266% | " data-sheets-numberformat="">322% | |
| "> | ||||||
Next, you will find below the income limit for adults by category.
Find the category you fall into and you will see the income limit by household size.
| ">California Medicaid Income Limit – Adults | ||||||
| ">Pregnant Women Medicaid | ">Adults (Medicaid) Parent/ Caretaker | ">Seniors & People w/ Disabilities (Medicaid) | ">Adults (Medicaid) Expansion to Adults | |||
| ">% FPL | " data-sheets-numberformat="">100% | " data-sheets-numberformat="">213% | " data-sheets-numberformat="">114% | " data-sheets-numberformat="">100% | " data-sheets-numberformat="">138% | |
| "> | ||||||
There are three ways to apply for Medi-Cal in Los Angeles County:
The BenefitsCal website is a fast, easy way for Los Angeles County residents to apply for and manage public assistance services online, including Medi-Cal.
With a BenefitsCal account, you can perform the following tasks online:
If you currently have a BenefitsCal account, click here to log in and apply for or manage your Medi-Cal benefits.
However, if you do not currently have a BenefitsCal, click here to sign up for one. It only takes a few minutes.
The video below does a great job of explaining in detail how to sign up for a BenefitsCal account, and apply for and manage your benefits online.
We recommend watching the video in order to save time in navigating the BenefitsCal website.
Applications for the Medi-Cal Program can be completed in person at a DPSS office location.
To begin the process you will need to locate the Social Services Regional Center that serves your area.
You should be prepared to spend a minimum of two hours at the Social Services Regional Center
Unless there is an emergent need for medical care, benefits may not be issued on the same day.
In addition to Medi-Cal, households can apply for CalFresh, General Relief, and CalWORKs at the following locations, which are open from 8 a.m. to 5 p.m. Monday through Friday:
See below for a list of DPSS office locations in Los Angeles County:
5445 Whittier Blvd.
Los Angeles, CA 90022
(866) 613-3777
813 E. 4th Pl.
Los Angeles, CA 90013
(866) 613-3777
211 E. Alondra Blvd.
Compton, CA 90220
(866) 613-3777
7555 Van Nuys Blvd.
Van Nuys, CA 91405
(866) 613-3777
3350 Aerojet Ave.
El Monte, CA 91731
(866) 613-3777
1740 E. Gage Ave.
Los Angeles, CA 90001
(866) 613-3777
4680 San Fernando Rd.
Glendale, CA 91204
(866) 613-3777
349-B E. Ave. K-6
Lancaster, CA 93535
(866) 613-3777
67 ADDRESS 337 E. Ave. K-10
Lancaster, CA 93535
(866) 613-3777 Programs
4077 N. Mission Rd.
Los Angeles, CA 90032
(866) 613-3777
2855 E. Olympic Blvd.
Los Angeles, CA 90023
(866) 613-3777
2615 S. Grand Ave.
Los Angeles, CA 90007
(866) 613-3777
2601 Wilshire Blvd.
Los Angeles, CA 90057
(866) 613-3777
2707 S. Grand Ave.
Los Angeles, CA 90007
(866) 613-3777
12727 Norwalk Blvd.
Norwalk, CA 90650
(866) 613-3777
955 N. Lake Ave.
Pasadena, CA 91104
(866) 613-3777
2040 W. Holt Ave.
Pomona, CA 91768
(866) 613-3777
11110 W. Pico Blvd.
Los Angeles, CA 90064
(866) 613-3777
9188 Glenoaks Blvd.
Sun Valley, CA 91352
(866) 613-3777
3352 Aerojet Ave.
El Monte, CA 91731
(866) 613-3777
27233 Camp Plenty Rd.
Canyon Country, CA 91351
(866) 613-3777
10728 S. Central Ave.
Los Angeles, CA 90059
(866) 613-3777
17600 A Santa Fe Ave.
East Rancho Dominguez, CA 90221
(866) 613-3777
17600 B Santa Fe Ave.
East Rancho Dominguez, CA 90221
(866) 613-3777
1819 Charlie Sifford Dr.
Los Angeles, CA 90047
(866) 613-3777
21415-21615 Plummer St.
Chatsworth, CA 91311
(866) 613-3777
2415 W. 6th St.
Los Angeles, CA 90057
(866) 613-3777
Here’s the phone number to call to speak to a live person regarding Medi-Cal in Los Angeles County:
Call the DPSS Customer Service Center at one of the following numbers:
Toll-Free (866) 613-3777
Local Numbers
Hours of Operation — excluding holidays:
Monday through Friday from 7:30 a.m. — 7:30 p.m.
Saturday from 8:00 a.m. — 4:30 p.m.
When you first qualify for Medi-Cal, you are covered under Medi-Cal Fee-for-Service.
However, you must choose a health plan within 30 days. If you do not choose a plan within 30 days, the State will choose a plan for you.
If you find only one health plan, the county has chosen this plan for you. Please wait for your health plan information mailer in the mail.
If you find multiple health plans listed, please explore each plan and choose the one that suits you and your family’s needs.
Below is a list of Medi-Cal Managed Care Health Plan options available in Los Angeles County, California.
| ">Plan Name | ">Phone Number |
| " data-sheets-hyperlink="http://www.healthnet.com/">Health Net Community Solutions, Inc. | ">(800) 675-6110 TTY/TDD (800) 431-0964 |
| " data-sheets-hyperlink="http://www.lacare.org/">L. A. Care Health Plan | ">(888) 839-9909 TTY/TDD (866) 522-2731 |
| ">Specialty Health Plan | |
| " data-sheets-hyperlink="http://www.altamed.org/seniorservices">AltaMed (PACE) | ">(877) 462-2582 TTY/TDD (800) 889-7862 |
| " data-sheets-hyperlink="http://brandmanseniorcare.org/">Brandman Centers for Senior Care | ">(855) 774-8444 TTY/TDD (818) 774-3194 |
| " data-sheets-hyperlink="https://lacoastpace.welbehealth.com/">LA Coast PACE | ">800-734-8041TTY 800-735-2922 |
| " data-sheets-hyperlink="https://pacificpace.welbehealth.com/" data-sheets-hyperlinkruns="">Pacific PACE | ">800-851-0966 TTY 800-735-2922 |
| " data-sheets-hyperlink="http://positivehealthcare.net/california/">Positive Healthcare | ">(800) 263-0067 TTY/TDD (800) 735-2929 |
| " data-sheets-hyperlink="http://www.scanhealthplan.com/">SCAN Health Plan | ">(877) 452-5898 TTY/TDD (800) 735-2929 |
When you enroll in (join) a Medi-Cal plan, you must choose a primary care provider (PCP).
Your PCP is the doctor or clinic you go to when you are sick or need a checkup.
To locate a Medi-Cal provider near you, click here to search the database of providers.
Once you are on the website, select a program (see image below) to search for doctors, dentists, hospitals, medical clinics, and dental clinics near you.
Here are some of the most frequently asked questions about Medi-Cal in Los Angeles County:
When you are approved for Medi-Cal, you will receive free or low-cost health coverage through a commercial or public insurance plan.
The specific benefits you receive from your plan may vary.
However, by law, each plan has to provide the 10 “essential health benefits” required by the Affordable Care Act (ACA):
The 10 essential Medi-Cal benefits you will receive from your health plan are:
Additionally, under Medi-Cal, a member may have full-scope or partial-scope coverage.
Full-scope coverage involves all Medi-Cal coverage, while partial-scope coverage includes some services.
Yes. Adults under the age of 26 are eligible for Full-Scope Medi-Cal benefits regardless of their immigration status.
Adults over 26 years of age can get Medi-Cal depending on their immigration status. Here’s what you need to know:
| ">Immigration Status and Medi-Cal Benefits for Adults Over the Age of 26 | |
| ">Immigration Status: | ">You may be eligible to: |
| ">Satisfactory Immigration Status | ">Full Scope Benefits |
| ">Non-Satisfactory Immigration Status | ">Restricted Scope Benefits |
Here are the Basic Medi-Cal eligibility requirements in Los Angeles County for Adults without Children:
Los Angeles County Medi-Cal Income Limits (Adults without Children)
| Family Size | 138% Poverty Level |
|---|---|
| 1 | 20,121 |
| 2 | 27,214 |
| 2 Adults | 27,214 |
| 3 | 34,307 |
| 4 | 41,400 |
| 5 | 48,494 |
| 6 | 55,587 |
| 7 | 62,680 |
| 8 | 69,773 |
| 9 | 76,866 |
| 10 | 83,960 |
| 11 | 91,053 |
| 12 | 98,146 |
| Each Additional Person | Add 7,094 |
If you make too much money to qualify for free Medi-Cal, you will have a Share of Cost payment.
A Share of Cost (also referred to as a SOC) is the amount of money an individual is responsible to pay towards their medical-related services, supplies, or equipment before Medi-Cal will begin to pay.
You only pay your Share of Cost in the month(s) you receive medical-related services, supplies, or equipment, including prescriptions and In-Home Supportive
Services.
After you meet your Share of Cost, Medi-Cal pays for your care for the rest of that month.
It depends. If you have a SOC or Share of Cost, you will need to pay that amount each month to your provider.
However, there are no other co-payment, premiums, or out-of-pocket expenses if you see and receive Medi-Cal-covered benefits through a Medi-Cal provider.
If you are not satisfied with your Medi-Cal health plan services, you have the right to:
Yes. If you are in a Medi-Cal health plan and want to choose another health plan for any reason, you may leave the health plan and join a different health plan.
Call Health Care Options (HCO), toll-free, at 1-800-430-4263 (TTY 1-800-430-7077).
They are available from 8 a.m. to 6 p.m. PT, Monday through Friday, except on holidays.
Alternatively, you can visit an HCO presentation site for help changing your health plan.
Also, you may also complete and mail an Enrollment Choice Form to Health Care Options.
To download an enrollment form, click here and select your county of residence.
L.A. Care offers high-quality, affordable health coverage to Los Angeles County residents, including Medi-Cal recipients.
Once you are approved for Medi-Cal in Los Angeles county, you can choose L.A. Care as your health plan.
When you join L.A. Care, you can choose to get your health care from L.A. Care or one of the other excellent Plan Partners they with to provide Medi-Cal coverage in L.A. County.
These include Anthem Blue Cross, Blue Shield of California Promise Health Plan, and Kaiser Permanente.
IHSS stands for In-Home Supportive Services.
It is a program that provides people with low income who are blind, disabled, or 65 years old or older with personal assistance and other services so they can live safely in their homes.
If you sign up for IHSS, you become a recipient and work with providers that help throughout your day.
Yes, As a Medi-Cal beneficiary in Los Angeles County, you are able to non-emergency transportation services to see your health care provider and to obtain medically necessary covered services at no cost.
You can use this service to:
We hope this post on Medi-Cal in Los Angeles County was helpful.
If you have further questions about Medi-Cal in Los Angeles County, please let us know in the comments section below.
Be sure to check out our other articles about Medi-Cal and California Medicaid program, including:
