Everything You Need to Know about the Medi-Cal Program and the Perks Linked with a Benefits Identification Card

The state of California was recently in news owing to its Medi-Cal Program. However, citizens of the state currently have more questions than answers when it comes to the benefits offered by this health care program.

So, for starters, you qualify for Medi-Cal benefits as soon as you get approved for SSI/SSP perks. It’s important to note that you can start availing of these benefits from the month you get deemed eligible for SSI/SSP.

Once the approval is granted, you will receive a plastic state of California Benefits Identification Card (BIC).

The Purpose of BIC

The Benefits Identification Card is used to confirm if you should receive Medi-Cal benefits i.e. to give permission to your Medi-Cal providers to bill for your healthcare services.

There is a chance that your doctor would inform you that you can only avail of the Medi-Cal benefits in a county where you don’t live. In that case, all you have to do is reach out to Social Security Administration (SSA) and request them to update their records.

Coming back to BIC, make sure that you never throw it away. In case you lose it, simply reach out to your social services office and request for a new card to be issued to you. As soon as you obtain one, your old card will be deemed invalid.

Paying for Medical Expenses after Applying for SSI/SSP

If a Medi-Cal doctor/provider provided you with medical and/or dental services after you got verified for SSI/SSP, they can charge Medi-Cal for those expenses. The coverage period, in this case, can be stretched back to a couple of months before your state of California Benefits Identification Card (BIC) was issued to you.

If you are concerned about payment for medical/dental services provided to you a year before you obtained your BIC, you must have a Letter of Authorization. You can get it by taking the following documents to your county social services office:

  • The SSA-issued letter or an award letter
  • Copies of your medical/dental bills (to find out the months in which you received the services)

Remember that you must file your request within six months of receiving the award letter.

Paying for Medical Expenses made Three Months Prior to the Date of your SSI/SSP Application

If you underwent any medical treatment during the 90-day period prior to your SSI/SSP application, you might be lucky enough to get those bills taken care of by the Medi-Cal program itself.

To get this assistance, you must be qualified for Medi-Cal during the aforementioned period. Moreover, you have a year to place this request. All you have to do is approach your county social services office and a representative will guide you to a Medi-Cal office near you.

Medi-Cal Managed Care Plan: What You Need to Know

Depending on your location, you might be able to register for the Medi-Cal managed care plan. But what does this plan include? Well, it is a health care program that enables you to avail yourself of medical services from a bunch of hospitals, clinics, physicians, etc.

In some California counties, this care plan is a must for everyone but in others, you get to choose whether to apply for it or not.

In case your county doesn’t support the said care plan, you are more than welcome to avail of these services through a medical/dental provider who is a part of the Medi-Cal program.

In order to find out about the availability of Medi-Cal managed care plans in your locality, you are recommended to reach out to your county social services office.

What to Do When the SSI/SSP is Halted?

If you are receiving SSI/SSP disability benefits, there may come a time when the SSA decides to cut off your benefits since you have overcome your disability barriers. In this case, you will obtain a notice stating that you will be eligible for availing of Medi-Cal benefits until your county social services office reconfirms that you qualify for other Medi-Cal plans.

Once this confirmation process is completed, you will receive an update clarifying your eligibility or ineligibility for the Medi-Cal program.

Additional Details You Must Keep in Mind

As a holder of the state of California Benefits Identification Card (BIC), there are certain things you must keep in mind if you are a Medi-Cal beneficiary:

  • Make sure not to exploit your Medi-Cal benefits by allowing others to use your BIC.
  • In case you are receiving medical/dental services from more than one provider, you should let each one of them know about the other(s).
  • You are allowed to have both Medi-Cal and a private insurance plan as long as the latter isn’t through a Prepaid Health Plan or Health Maintenance Organization.
  • In case there is any fluctuation in your income, lifestyle, or resources, inform SSA at your earliest.
  • You must document when you avail of Medi-Cal services due to incurring an accident/injury caused by someone else.

For those of you who do not have Social Security perks, feel free to apply for Medicare benefits at a nearby SSA if you are at least less than 3 months away from turning 65.

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