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Human Services Agency of San Francisco
Department of Aging & Adult Services * Department of Human Services

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Medi-Cal

Medi-Cal is a public health insurance program that offers eligible individuals and families access to free or low-cost health care coverage. SFBenefits Netís staff is committed to helping all San Franciscans access free or affordable health care coverage.

Who can Qualify for Medi-Cal?

Medi-Cal covers low-income adults, families with children, seniors, persons with disabilities, children in foster care as well as former foster youth up to age 26, and pregnant women.

The Affordable Care Act established a new methodology for determining income eligibility for Medical, which is based on Modified Gross Adjusted Income (MAGI). MAGI is the basis for determining Medi-Cal income eligibility for most children, pregnant women, parents and adults; this program exempts resources.

Individuals whose eligibility for Medi-Cal is based on blindness, disability or aged (65 or older) are exempt from the MAGI methodology; their eligibility is based on Non-MAGI rules.  Under Non-MAGI rules resources are counted. For resources requirements, see Medi-Cal resources guide.

Note:  US citizenship and immigration status are not a condition of eligibility.  To learn more about how immigration status impacts your coverage, go to Frequently Asked Questions.

How do I Apply for Medi-Cal?

  • You can apply online at https://www.mybenefitscalwin.org/  or http://www.coveredca.com/
  • Apply over the phone or in person
    Toll Free (855) 355-5757
    1440 Harrison Street or 1235 Mission Street
    San Francisco, CA 94103
    Monday - Friday from 8:00 a.m. to 5:00 p.m.
  • You can also submit your application via mail, email or fax
    Human Services Agency
    PO BOX 7988
    San Francisco, CA 94120
    SFMedi-Cal@sfgov.org

Fax:  415-355-2432

 

What Happens After I Apply?

  • Once your application is received and assessed for eligibility, you will receive a Notice of Action listing the eligibility of each individual in your household. If additional information is required to make a determination, a worker may contact you by mail or phone to request the needed information.
  • If you do not understand your Notice of Action letter or do not agree with the listed information, you can contact our office. If you still disagree with the decision, you may file for a State Hearing by completing the back of your Notice of Action.
  • Every eligible person in your household will receive a Medi-Cal Benefits Identification Card (BIC). Take this card with you any time you see a health care provider.
  • Most individuals eligible for full scope Medi-Cal are required to choose a health plan. For more information call the Health Care Options office (800) 430-4263.

What Services Does Medi-Cal Cover?

·        Medi-Cal coverage pays for medical visits, hospital care, prescription drugs, pregnancy-related treatment, dental and eye care, and other medical services. Some dental services are covered. Be sure to talk with your dentist to see what Medi-Cal covers before receiving treatment. For information, see Medi-Cal Benefits.

What if I am not eligible for Medi-Cal?

Those who are low income but not eligible to Medi-Cal  can purchase affordable private health insurance offered by Covered California. To learn more about Covered California please visit:

You can also click on these links for other helpful resources.

 

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