Making Medi-Cal Work for Your Special Needs Child

Medi-Cal is California's medical assistance program that operates as the states's Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level. 

IMPORTANT: Pregnant women, children, and disabled persons are allowed to have a higher income on the Federal Poverty Level scale.

Medi-Cal pays for a long list of medically necessary things including medical treatments, medications, adult day healthcare, hospitalization, skilled nursing care, home care and even durable medical equipment. 

If your child is approved for Medi-Cal but you are unable to pay the monthly "share of cost," you and your children may be eligible for other less costly Medi-Cal programs. 

Whenever possible, a parent should try to obtain Medi-Cal coverage for their child through the local regional center using a special program called “Institutional Deeming.” This program enables children ages 3 to 18 to receive coverage under full-scope Medi-Cal who would normally not be eligible because their family income is too high. Under the Institutional Deeming program, only the income and resources of the child are considered when determining eligibility. It's important to note that a child under the age of 3 may also qualify if he or she has been diagnosed with a developmental disability rather than only a delay.

If your child doesn't qualify for Institutional Deeming, standard Medi-Cal eligibility is based primarily on household income. To find out if you and your family may be eligible based on income, you can use the Covered California Income Guidelines chart.

Aside from going through your local regional center, there are multiple ways to apply for health coverage in California for you and your family.

If you need additional help applying or have additional questions, you can contact a trained Certified Enrollment Counselor (CEC) for free. Search a list of local CECs or simply call 1-800-300-1506.

Want to zip through the process fast? Here are four tips from the Department of Health Care Services to speed up your application process.

If you'd like to learn more about Medi-Cal, IHSS, CCS, and other California programs, please feel free to message us here at California Advocacy Group at any time.