Understanding Medi-Cal Eligibility and Access: Who Can Find Information?

Medi-Cal is government-funded health insurance for eligible participants in the state of California. Due to Health Insurance Portability and Accountability Act laws, the only people who can find out who has Medi-Cal benefits are providers or the participants themselves. Participants need to meet certain requirements, as well as be within the income and resource limits set by the state of California.

Instructions

How Medi-Cal Providers Can Find Who Has Medi-Cal

• 1

  Log onto the State of California's Medi-Cal database.

• 2

  Search by the person's name, social security number, or benefit identification card number.

• 3

  Check the eligibility codes to determine whether the person's eligibility is active.

• 4

  Call the private Medi-Cal eligibility phone number when you need to verify questionable items, such as when the codes show that a member is inactive although they believe they are eligible, when there are questions regarding the amount due from the patient, or when there are questions concerning other healthcare coverage.

• 5

  Instruct the patient to call their Medi-Cal worker if unable to verify eligibility.

How to Find Out if You or Your Dependents Have Medi-Cal

• 6

  Locate the phone number to your local Medi-Cal office.

• 7

  Call the Medi-Cal office and ask to speak to your caseworker. You will be asked for your case number and/or social security number.

• 8

  Ask your worker for the status of your family's Medi-Cal eligibility. You may need to reapply for some or all members.