In a few months, California will begin providing full Medi-Cal coverage to all low-income children 鈥斅爎egardless of their immigration status.
, anywhere from 170,000 to聽 children who live in California and are in the country illegally will qualify.
If you think your child will, or know a parent whose child will, state officials and health care advocates have a simple message for you: Take action now. 鈥淪ign up today,鈥澛爏ays聽Rachel Vizcarra, a program assistant with the聽 in Bakersfield, which is helping families pre-enroll. 鈥淚f you do, your kids will be automatically enrolled into the program.鈥�
State officials expect coverage to start May 16. But because the policy shift requires complex programming changes to state and county computer systems, implementation may be delayed, says聽Tony Cava of the .
No matter when it occurs, eligible children will gain coverage retroactive to the first day of that month, he says. For example, if the change takes place on May 16, coverage will extend back to May 1.
Carolina Moran of Canoga Park looks forward to taking her 14-year-old daughter Lizeth to the doctor once she becomes eligible for full Medi-Cal benefits.
A concussion on the soccer field sent Lizeth to the emergency room in January, but she couldn鈥檛 see a doctor for a follow-up visit because 鈥渨e couldn鈥檛 afford it. We would have to pay out of pocket,鈥� Moran says.
The first thing Moran will do is take Lizeth for a physical 鈥渁nd make sure her vaccinations are up to date,鈥� she says. 鈥淪he also needs fillings for five cavities.鈥�
Medi-Cal eligibility is based on household income, and children under the age of 19 qualify at a higher income level than adults. They鈥檙e eligible for Medi-Cal if the family鈥檚 household income is less than 266 percent of the聽, or about $53,600 for a family of three and $75,650 for a family of five.
Currently, children and adults in the country illegally qualify for limited Medi-Cal coverage, called restricted-scope, which covers emergency and pregnancy-related services.
Though this may sound counter-intuitive, health care advocates and the state want you to sign your kids up for restricted Medi-Cal now in preparation for the availability of full Medi-Cal benefits.
The idea is that when the change occurs, qualified children into full-scope Medi-Cal 鈥渨ithin a few days鈥� and without an additional application, Cava says.
The state estimates that there are about 115,000 unauthorized immigrant children who already have restricted Medi-Cal.
If your child is uninsured, sign up for restricted-scope Medi-Cal now. Even if your child has coverage through another existing program 鈥斅爏uch as Kaiser Permanente鈥檚 or county-based health coverage 鈥斅爕ou should still sign him/her up for restricted Medi-Cal now, says Mark Diel, CEO of聽 (CCHI), a statewide outreach and enrollment network.
That鈥檚 because those kids will eventually become ineligible for those programs after they become eligible for full Medi-Cal, he says. (Don鈥檛 drop out of another program until you confirm that your child鈥檚 full-scope Medi-Cal has been approved, he says.)
But be warned: The Medi-Cal application is long and complicated. To complete it, you鈥檒l need to provide a birth certificate, proof of local address, proof of identity and income information, Vizcarra says. Foreign passports and birth certificates can be used.
鈥淲ork with a local enroller instead of trying to do it on your own,鈥� Diel says. 鈥淵ou鈥檙e much more likely to get the application approved.鈥�
Help from local health clinics and community groups is free. Online, visit聽 for local resources.
Advocates and state officials also want you to know that enrolling your kids shouldn鈥檛 lead to negative immigration consequences for you 鈥斅爋r other members of your family 鈥斅爓ho may not have legal status.
鈥淣one of the information being collected is shared with immigration authorities,鈥� says Maria Romero-Mora of CCHI.
Once you get your kids into restricted-scope Medi-Cal, and eventually into full Medi-Cal, you鈥檒l need to take action. before and after the transition explaining your options.
CHOOSE A PLAN: Once the transition to full Medi-Cal occurs, you will have 60 days to choose a managed care health plan for children already enrolled in restricted-scope Medi-Cal. If you don鈥檛 choose a plan, the state will assign one, Cava says.
Parents of kids who are not in restricted-scope Medi-Cal at the time of the change and who enroll them afterward will have 30 days to choose a plan, he says.
If you live in one of 22 counties where Medi-Cal managed care is operated by a single聽, children will be automatically enrolled in that plan, Cava says.
In all cases, until a plan is chosen 鈥斅爋r assigned 鈥斅燾hildren will receive coverage through Medi-Cal鈥檚 fee-for-service program.
PAY PREMIUMS: Medi-Cal is premium-free for kids up to 160 percent of the Federal Poverty Level, but you will owe a premium if your family income falls between 160 percent and 266 percent. The premium is $13 a month for each child, with a $39 family maximum.
Children in Medi-Cal plans don鈥檛 have co-payments for medical care.
RENEW: You will need to participate in Medi-Cal鈥檚 annual renewal process to ensure your children remain eligible and enrolled.
Finally, if you don鈥檛 sign your child up for restricted Medi-Cal before the change, you can apply for full benefits afterward 鈥斅燼nytime of year 鈥斅燼t your county human services office, through a community organization or via the 飞别产蝉颈迟别,听.
In Canoga Park, Moran says getting Lizeth on Medi-Cal will give her family greater financial security. Lizeth agrees.
鈥淚 worry that if I have to go to a checkup, it鈥檚 going to cost my parents money, and sometimes they don鈥檛 have the money to pay for it,鈥� the ninth-grader says.
This story was produced by , which publishes , a service of the .