Information for Families to Know in Preparing to Apply

Medi-Cal Enrollment is private.

  • Information provided on Medi-Cal applications is confidential and can only be used to determine eligibility (unless there is fraud on the application).
  • Long-standing federal guidance provides that states cannot ask for the immigration status of non-applicants applying for Medicaid (Medi-Cal) for eligible family members.

Enrollment does not affect public charge, with a few exceptions.

  • Using Medi-Cal will not cause children to be considered a public charge ( i.e., hurt their ability to become a permanent resident).
  • Exception: institutionalization for long-term care at government expense.

Options to show proof of income

  • All records and family income information are kept confidential and will not be used for any other purpose other than verifying income eligibility for Medicaid.
  • Typically, counties are first required to seek out information from the employer, if it’s available. Sometimes employers do not like to provide this information, even though it is kept confidential. In that instance, the county will work with the applicant to determine the nature of the employment and provide them with the available options to verify income. For instance, if the individual is:
    • A day laborer who has different jobs on a daily basis, the county will provide them with some sort of affidavit or calendar that they can fill out to indicate their earnings;
    • Self-employed, the county may ask them to fill out profit and loss statements to show their earnings;
    • Consistently employed and paid via personal check (rather than a business account), a copy of the check can be provided; or
    • Consistently employed but paid in cash, the county will ask the individual to provide some sort of affidavit or statement regarding their income.

Some Families May Have to Pay for Medi-Cal

  • Medi-Cal requires modest monthly premiums ($13 per child and up to a maximum of $39 per family) for families with monthly incomes above $3,234 for a family of 4 (160 percent of the federal poverty level).
  •  Premiums also apply for restricted-scope Medi-Cal, so families subject to premiums may not find it worth it to enroll in restricted-scope Medi-Cal in advance of the expansion.
  •  Medi-Cal does not require co-pays for children.
  •  A monthly premium is not the same as a co-pay. A premium is the monthly amount paid for insurance, whereas a co-pay is the amount paid at the time services are rendered, such as for doctors’ visits or at the pharmacy.
  • The child’s premium is paid to Medi-Cal monthly, but there is no cost for the children when they get any of the Medi-Cal services. No one should have to pay a co-pay for doctors’ visits, treatments or procedures, or medication.

Additional Resources

  • Western Center on Law and Poverty’s guide includes information on privacy and public charge in Appendix B.
  • Western Center on Law and Poverty’s guide also includes information on Medi-Cal children’s programs, including the premium program, on page 2.54.