Eligibility and Application

You can think of Medi-Cal as a single program that you can qualify for in many different ways. These different ways are called eligibility categories. For example, SSI-Linked Medi-Cal is an eligibility category that allows people who qualify for SSI to automatically get Medi-Cal. There are over 90 eligibility categories, each with its own rules and requirements. Once you meet the requirements of an eligibility category, you are eligible for either full or partial-scope Medi-Cal.

DB101 describes the four eligibility categories that people with disabilities most often use:

  • If you qualify for SSI (Supplemental Security Income), you are automatically eligible for SSI-Linked Medi-Cal
  • If you are aged or disabled, you may be eligible for Aged & Disabled Federal Poverty Level Medi-Cal
  • If you are disabled and working, you may be eligible for California’s Working Disabled Program. You will have to pay a small premium for Medi-Cal coverage, but you can have countable income up to 250% of the Federal Poverty Level
  • If you are aged, blind, or disabled, but your income is too high for other Medi-Cal programs, you may be eligible for Aged, Blind, and Disabled – Medically Needy Medi-Cal. For this program, you may need to spend a certain amount of your own money before Medi-Cal begins to pay for medical services. This payment is called a share of cost.

You don’t need to do anything extra to get SSI-Linked Medi-Cal. Just apply for SSI by calling 1-800-772-1213 (voice), 1-800-325-0778 (TTY) or by visiting your local Social Security office. You can apply for the other categories at your local county welfare office. Also, there are Medi-Cal eligibility workers at many hospitals and clinics who can process applications.