What is Medi-Cal?
Medi-Cal – California’s Medicaid program – provides free or reduced-cost health coverage for low-income individuals and families. Medi-Cal increases patients’ access to important healthcare services, such as doctor visits, immunizations, hospital care, and the 10 essential health benefits.
Medi-Cal Eligibility Requirements
Medi-Cal primarily serves individuals and families who are generally below 138% of the Federal Poverty Level for adults and 266% for children. Others who are eligible for Medi-Cal include (but are not limited to): newborns, foster care youth, pregnant women, persons with disabilities, and seniors. You can find out more information about Medi-Cal eligibility here.
How many children are in Medi-Cal?
Medi-Cal is the largest state Medicaid program in the nation, covering nearly half the children in California. It is estimated that a total of 5.2 million youth are currently enrolled in Medi-Cal. Children's hospitals provide over 1.9 million outpatient visits each year across the state, regardless of income or payer source. Among our 8 member hospitals, Medi-Cal funds over 60% of inpatient and outpatient visits.
Unfortunately, Medi-Cal reimbursement does not usually cover the basic costs of care for children's hospitals. This is a major concern, because children's hospitals typically provide lifesaving care for children with serious conditions -- care that can be complex and costly. Although Medi-Cal does not sufficiently cover costs, it is still an important payer for children’s hospitals.
The Affordable Care Act (ACA) has expanded coverage to populations that were previously uninsured. Since the ACA was passed into law in 2010, nearly 1 million more youth have been enrolled in Medi-Cal.