Starting April 1, Californians who depend on Medi-Cal — the state's Medicaid health care program — for their health care expenses will need to once again go through a redetermination process to renew their eligibility and keep their Medi-Cal coverage.
Thanks to the federal COVID Public Health Emergency (PHE) declared in 2020, Medicaid programs around the nation like Medi-Cal have been able to waive annual eligibility requirements. This means that for the past three years, Medicaid beneficiaries had their health care costs covered without having to go through an annual renewal process, which could have found them no longer eligible to receive Medicaid.
But at the end of last year, Congress approved the Consolidated Appropriations Act — putting an end date of March 31 on automatic Medicaid renewal.
Who will be affected by these Medi-Cal changes?
This change will affect the millions of people nationwide who depend on Medicaid to cover essential care, prescriptions and other health care services, including the 12 million people enrolled in Medi-Cal within California.
The Urban Institute, a public policy think tank, released a study at the end of 2022 that estimates that 18 million people nationwide may lose their Medicaid coverage during a 14-month period following the end of the PHE — either because they are found to no longer qualify for Medi-Cal, or because they fail to renew on time. In California, that number could be as high as 3 million.
Disability rights advocates also worry that the renewal process could leave people without health coverage. "Administrative and procedural barriers can also lead to someone being dis-enrolled, with low-income people and people of color disproportionately at higher risk due to structural inequities," wrote San Francisco disability rights activist Alice Wong in a recent column for Teen Vogue.
Individuals who received Medi-Cal benefits before the pandemic began may remember what it’s like to renew eligibility: Your county’s health and human services agency sends to your mailbox a thick packet full of forms to fill out and verify your residency, income, health information and other personal details.
But regardless of whether you have been on Medi-Cal for decades, or joined far more recently during the pandemic, the redetermination process will be required for all Medi-Cal beneficiaries. This means that every single person on Medi-Cal needs to be aware of the coming changes starting in April, to make sure they keep health care coverage in some form.
Keep reading for what you need to know.
On Medi-Cal? Here's what to expect starting April 1
Nobody will be automatically dropped from their Medi-Cal coverage on April 1, says María Reyes, community health education manager for La Clínica de la Raza, which provides health services to lower-income communities in Alameda, Contra Costa and Solano counties.
Instead, that date marks the start of the process to reenroll people on Medi-Cal.
Once the Medi-Cal renewal waiver ends on March 31, there will be two ways people can renew their benefits: through the mail or online at the Medi-Cal website. But it's important to remember that the deadline to renew will be different for everyone, says Reyes.
The deadline to renew your personal coverage, she says, is based on your Medi-Cal "anniversary":
- If you had Medi-Cal before 2020, your anniversary is the date when you last renewed your coverage before the pandemic, but:
- If you enrolled after 2020 and haven’t gone through the renewal process yet, your anniversary falls on the date you first applied.
Reyes recommends that you confirm the exact date of your coverage anniversary — because you should receive a renewal packet in the mail ahead of this date.
Option 1: Renew your Medi-Cal coverage by mail
"As people meet their anniversary date, they'll be getting these packets," she says, adding that the packets will include a letter with information specific to your coverage. "This letter will let you know you have X amount of time, from the time you receive the letter, to submit your renewal packet and the documents they are requesting from you."
These packets will be going out in phases monthly up through June 2024, and will include an annual redetermination form (PDF) which asks for information about a beneficiary’s income, living situation and disability status, among other factors. You may be asked to submit additional documents depending on your circumstances. You should fill it out and return it as soon as possible, if you don't plan on renewing your Medi-Cal online (see Option 2).
"If, for some reason, your county office doesn't get the packet by the deadline, they'll send another reminder letter letting you know they haven't received your documents," Reyes said, adding that there may be a third letter in the mail if a beneficiary misses the second deadline. There should, she assures, be several opportunities for people to be reminded of this deadline. "It's not going to be a sudden stop of services," she said.
Option 2: Renew your Medi-Cal coverage online
In some cases, you may be able to renew online. In the Bay Area, counties use either one of two renewal portals:
- If you live in Alameda, San Francisco, San Mateo, Solano and Sonoma counties, visit MyBenefitsCalWin to renew your Medi-Cal.
- If you live in Contra Costa, Marin, Napa or Santa Clara counties, visit BenefitsCal to renew your Medi-Cal.
If you live somewhere else in California, see which website your county uses for your to renew your Medi-Cal.
What if I am found to no longer be eligible for Medi-Cal?
If you don't renew your Medi-Cal by the deadline (see Options 1 and 2, in the previous section), or are found to no longer be eligible, you'll be removed from Medi-Cal coverage. And if that happens, you'll have other options for subsidized health care coverage — but at a cost.
Yingjia Huang, assistant deputy director for health care benefits and eligibility at the Department of Health Care Services, told CalMatters that if you no longer qualify for Medi-Cal because your income has gone up, you'll be "automatically" transitioned into a similar plan through Covered California. "The system automatically will review their eligibility for Covered California, and Covered California will send out the enrollment notice to the member, informing them of their options and to pay the plan premium," said Huang. There'll be "no administrative burden on a member," she stressed.
But of course, this may come with a new monthly premium that many folks on Medi-Cal haven't had to pay before — and might not feel able to when factoring in their other expenses.
The state emphasizes that nearly half of people getting health care through Covered California pay less than $50, while nearly a quarter of people don't pay a monthly premium at all.