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A photograph of a person with lighter skin in medical uniform wearing a stethoscope, attending to another person whose face we can't see, wearing a beige shirt.
Medi-Cal eligibility changes mean you'll need to take action to keep your coverage, starting April. (Thirdman/Pexels)

On Medi-Cal? Eligibility Changes Starting in April Could Mean You Lose Coverage. Here's What to Do

On Medi-Cal? Eligibility Changes Starting in April Could Mean You Lose Coverage. Here's What to Do

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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.

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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.

A photograph shot from behind of two people, whose faces we can't see, operating a laptop to fill out a form.
Changes are coming to Medi-Cal eligibility, and you’ll have to act to keep coverage. (RODNAE Productions/Pexels)

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.

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What happens if I don’t get my renewal packet in the mail?

Reyes is keen to reiterate that no one will be automatically dropped from their Medi-Cal coverage on April 1. “Starting on that date, people should be on the lookout for these renewal packages that they will need to complete,” she said.

If your coverage anniversary rolls around and you have not received a renewal packet, there may be several possibilities to explain why:

  • You may have the wrong date on file for your anniversary, or:
  • Your county may be sending the packet to an old address (more likely if you moved during the pandemic).

In either case, you should confirm your information with your county directly. You can do this online:

  • If you live in Alameda, San Francisco, San Mateo, Solano and Sonoma counties, visit MyBenefitsCalWin to update your Medi-Cal contact information.
  • If you live in Contra Costa, Marin, Napa or Santa Clara counties, visit BenefitsCal to update your Medi-Cal contact information.

You can also contact the office in your county that manages Medi-Cal enrollment. Find your county in the list below.

Get direct assistance with Medi-Cal and update your contact details

Alameda County: Social Services Agency, 24100 Amador Street, Hayward; call (888) 999-4772.

​Contra Costa County: Employment and Human Services, multiple addresses; call (866) 663-​3225.

Marin County: Health and Human Services, 120 N. Redwood Drive, San Rafael; call (877) 410-8817.

Napa County: Health and Human Services, 2751 Napa Valley Corporate Drive, Napa; call (707) 253-4511.

San Francisco: Human Services Agency, 1440 Harrison Street, San Francisco; call (415) 558-4700.

San Mateo County: Human Services, 400 Harbor Boulevard, Building B, Belmont; call (800) 223-8383.

Santa Clara County: Social Services Agency, 1867 Senter Road, San José; call (408) 758-3800.

Solano County: Health and Social Services, multiple addresses; call (707) 784-3900.

Sonoma County: Department of Human Services, 2550 Paulin Drive, Santa Rosa, or 5350 Old Redwood Highway, Suite 100, Petaluma; call (877) 699-6868.

Remember, you don’t have to go through this alone

If you are a parent or caregiver and managing a family all by yourself, working multiple jobs or managing a chronic illness, the Medi-Cal renewal process is another item on a long list of responsibilities you are already juggling. You might also be facing a drop in your CalFresh benefits (SNAP, or food stamps) at the same time as this Medi-Cal renewal, starting in April.

Many organizations across California are helping folks send their renewal packets in on time and keep their coverage. One of them is La Clínica de la Raza, which has set up a service that provides individual assistance to Medi-Cal recipients living in Alameda, Contra Costa or Solano counties while completing the renewal requirements.

“We don’t want people to lose coverage, especially because preventative services are important — particularly for those who have chronic conditions,” said Reyes, from La Clínica. “We want to make sure that they’re not at risk of losing coverage, not being able to see their provider, not able to refill their prescriptions. So taking action as soon as possible is important.”

If you are on Medi-Cal and live in Alameda, Contra Costa or Solano counties, contact La Clínica de la Raza at (855) 494-4658. Help is available in both English and Spanish.

Reyes adds that your county’s social services agency is also a helpful resource when navigating the renewal process and some counties have even set up service centers to answer reenrollment questions in person. Find contact information for your county’s social services agency (above).

Tell us: What else do you need information about?

At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area in 2023. We’ve published clear, helpful explainers and guides about issues like COVID, how to cope with intense winter weather and how to exercise your right to protest safely.

So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.

KQED’s Carly Severn contributed to this story.

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