Advice about Medi-Cal

Parent Q&A

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  • I am new to Medi-Cal and I need to decide between Alameda Alliance and the medi-cal version of athem blue cross. Does anyone have an experience with these two health care options? On paper they seem very similar, but I imagine in practice they have so pros and cons.

    I am also looking for a primary care provider who takes one of these versions of Medi-Cal. I've been to Lifelong Medical, which is the main medi-cal provider in my area. They are clearly over burdened, and it is hard to get an appointment, and once I got an appointment I still waited hours (literally) in the waiting room. I know there are other providers that take medi-cal but it's hard to find out who they are! If anyone has advice I'd be grateful!


    **for anyone reading this post looking for prenatal care or an ob/gyn who takes medi-cal, Sutter East Bay on 2500 milvia takes pregnancy Medi-cal (their primary care physicians do not take it, or at least that is my understanding)**^

    If you've been a Kaiser member in the past 6 months (or have a family member living in the same household as you who's a current Kaiser member), you can request Kaiser through Alameda Alliance.

  • I will be finalizing my divorce soon and will need medical insurance for myself since I will no longer be under my ex's. I was a SAHM and do not currently have full time employment.  I am looking for recommendations of companies to contact and the best pricing for medical.  If you have any tips or have gone through this and can give me some insight, I would really appreciate it. Thank you!

    You can get decent insurance through Covered California and since it's based on income and family size, you'll pay very little. I'm a self-employed single mom with a 5-year-old, making $45K, and I pay about $20/month for both of us on a PPO Blue Shield plan. The deductibles are high, but my needs are low, so it works for us. Their online application process is a little frustrating, so have a glass of wine next to your computer and you'll be fine.

    Part of the divorce settlement is that he should cover you, at least for a period of time. You will have a very hard time getting insurance that is affordable until the next open enrollment window of the ACA. Where was your attorney in this?

    You can still sign up for Covered CA. Per "Medi-Cal enrollment is year round. Additionally, individuals who experience a qualifying life event may be eligible to enroll in private coverage through Covered California by applying for special enrollment." Your divorce and loss of coverage is a "qualifying lift event."

  • Have you successfully gotten a young adult dependent covered by Medi Cal?  My young adult daughter (21 in a few months) graduated from high school two years ago and has neither worked nor gone to school since then.  There are substance abuse and emotional issues.  My daughter currently is covered as a dependent on my health insurance plan.  Recently she looked at a program which she and her therapist feel would be a good fit for her, but it turns out that its clients are almost exclusively Medi Cal patients.  My insurance doesn't cover it.  Other programs we've looked at are covered by insurance, but with a hefty deductible and co-pay that I, approaching retirement age, cannot afford.

    I think it would be a step towards independence for my daughter to apply for Medi Cal (with help, of course).  I would very much like to know the ins and outs of the process.  As one example, while of course Medi Cal is a statewide program, are there specific offices that are easier to deal with than others?  Generally, how long does the process take from application to decision?  

    Feel free to contact me directly.  Thank you in advance!

    My son went through this process. MediCal is now part of the Covered California system. You need to get your daughter to go to that website and apply for coverage. Please note that she will need undoubtedly NOT qualify if she is still covered by your insurance plan; I can't recall if you can enter a date after which time she will not be covered, as that would be the time that she would become eligible. After she's answered all the questions, Covered California will respond that she does not qualify for subsidized premiums but that she "may" qualify for MediCal. What that really means is that her application for coverage has been ported over to the MediCal system, which after they review it and decide that she does in fact qualify, will lead to your daughter's getting the slew of papers, etc. about actual coverage. Once you get to that point is when you might want some help navigating the choices. We found the people at Lifelong Medical Care (multiple offices) to be very helpful.


My husband and I were in a similar situation last year.  We were both unemployed and found out we were expecting our first child.  I called Covered California to see what kind of health care we qualified for.  The staff there helped us get MediCAL.  MediCAL is based on income, not savings.  It was the biggest blessing and such a life saver.  

Archived Q&A and Reviews



FTM COBRA vs Medi-Cal insurance coverage

May 2013

We're recent transports to the area from Washington, DC and are expecting our first in June! As you can imagine, lots of transitions. I have the ability to either elect COBRA coverage from my DC job or get Medi-Cal as a consultant/self employed person. Aside from the obvious cost difference, I'm looking for advice on Medi-Cal in pre-natal and post-natal care (including for baby). Is it comprehensive? Would you recommend going the tried and true and expensive COBRA route instead? Looking for local advice as this is a completely new world for me - I've always had an insurance plan until now. Thanks so much.

If you have any substantial income at all you will probably not qualify for Medi Cal. You need to prove your income, show bank statements, tax returns etc. and just being self-employed does not mean you will qualify. Also, if you just move here from another state, I suspect there is some residency requirement in order to qualify. Additionally, under the new Health Care Law your employer is required to cover you but only if they employ 50 or more employees, otherwise they still do not have to cover you. However, if you do not have health insurance, beginning in 2014, you personally will receive a fine through your income tax. human resource person

Help to Legally get Medi-cal & Protect Assets

Jan 2013

My daughter is having some major ''issues'' & needs to get financial assistance & medi-cal, soon. She does have a few assets that may put her over the limit for public assistance. Reading on.line, there is legal help that can help to guide her through a ''spending down'' process, so, with these few assets, she can still qualify to get the financial assistance & medi-cal assistance she needs more quickly, & wisely. Often, this help may pertain the an elder person, who has assets to protect, so they can enter a nursing home, but basically the same principals apply. I don't want to close my eyes & just ''pick someone out''. Have you had experience or can you recommend someone you've used that has done this sort of work? Perhaps it could be a low cost agency. She happens to be in San Mateo. Thank you. anon

If your child is a client of the Regional Center, I'd start there to get help on the medi-cal waiver. Otherwise, request to speak with the social worker at the hospital/specialty clinic where your daughter receives care. You can also check with the family resource center for a referral. I'm not sure the name of the resource center in San Mateo; in SF it's Support for Families. anon

I'm sorry to hear your daughter is going through this. This is definitely an area where you need to be careful. I specialize in elder and dependent abuse law and have seen (and sued) my fair share of charlatans who will tell you they can ''pre-qualify'' someone for Medi-Cal. Frequently, these people charge exorbitant amounts of money and perform legal work when they aren't qualified to do so. And they give bad advice and mess things up. I recommend calling California Advocates for Nursing Home Reform,, to see if they can either, 1) give you advice about this, or 2) refer you to someone reputable. Good luck! Sarah

Affordable medical insurance for kids

Oct 2012

Dear BPN, We live in SF right now but planning to move to East Bay (Oakland or Berkeley) in near future. My 4 month old is eligible for Healthy Kids program, which is part of San Francisco Health Plan. Do you recommend any affordable insurance program that is similar to Healthy Kids? Thank you! Miko

If your 4 month old qualifies for Healthy Kids, s/he'll probably qualify for Healthy Families, the statewide program: L

I am in Oakland. The insurance I have is Healthy Families. I have Alameda Alliance for Health through Healthy Families. There are $10 copays for doctor's visits and prescriptions and my son's premium is $20/month. The premium is based on income and I'm not sure how that changes between income brackets. Vision and dental are also covered. The number listed on my son's bill is 1-888-439-4741. Affordable health insurance for my child

MediCal and inheritance

April 2012

An older couple (neighbors) came from Europe and signed up with MediCal as their income was low (with large copay). Now they are inheriting some money, and they think MediCal has the right to get paid retroactively for services received until now. They would like to find out more about that, and need legal help. Any suggestions? Thanks. Susan

Senior Medi-Benefits in Berkeley may be able to help answer Qs, or at least be a starting point. They are a fantastic non-profit focused on serving the needs of the elderly, veteran and disabled populations. www.seniormedi- or 888.789.4589 A grateful former client

Medi-cal became unaffordable when I got a raise

August 2008

I am at the end of my rope and I'm wonder if anyone out there can help. I am a single mom of a ten year old girl and ever since she was born I have had Blue Cross Medi-cal. Suddenly because I started to make slightly more a month (maybe $100. more), medi-cal has given me a ''share of cost'' of 1100. a month. I went in to bring pay stubs to show my income had not gone up that much and recieved a notice in the mail that since it had gone up by $2000. or so dollars(huh?)now my share of cost is around $2500. a month. That is more than I have ever made per month, I sometimes make less because I am in education and seasonally my income goes down or disappears altogether.

From this I can only come to the conclusion that my worker is either crazy, drunk, or even worse discriminating against me for an unknown reason. Meanwhile my daughter's asthma is getting worse and I cannot afford her medications or even take her to the doctor. Since kids can die of asthma, that is a big concern. I am stressed to the limit and don't know how much longer I can hold up. To top it up my income goes up and down to the point that I am afraid of being evicted and becoming homeless. I am seeing a therapist but that is paid by, you guessed it, Medi-cal. I have no real supportive family. I am a paraeducator (7 years experience) and the only jobs I can get are seasonal (summer) or part time school district jobs plus seasonal after school program jobs.I have 2 bachelor's degees. I am close to getting my teaching credential and consider myself good at what I do but I do not have the time or babysitting to go back to finish school.

Communicating with the medi-cal people is next to impossile because they have an automated phone system and I have to take off work to go in there and wait to see a very unhelpful person. My daughter's father is not helping and it would take six months to a year to get a fair amount of child support. I beleive it would involve court. I am applying for Healthy Families for my daughter but it won't cover me and I am on meds too. Help, my life has become unliveable. Any advice would be appreciated. anonymous

I'm not sure if you received other replies to your post. I saw yours a few weeks late. I just wanted to share my experience with Medi-Cal (Alameda County). It was a nightmare. I had Kaiser Medi-Cal in Oakland for my (then) 1-year-old daughter, but moved to SoCal and needed Alameda County to officially change my address and transfer the file. I couldn't enroll in a plan in SoCal until that happened, so even though I officially had Medi-Cal for my daughter, we really only had emergency coverage at the VERY overburdened county hospital.

After NINE MONTHS of calls and letters to my case worker, the Medi-Cal coverage was cancelled because I didn't send in certain forms, which of course I never received because my address STILL hadn't been changed in the system. At that point I filed for a hearing, and finally things moved forward. The file was transferred and coverage was restored (although even that took about 4 months). My advice to you is to file for a hearing so that your case worker receives some oversight. I think (but I'm not completely sure on this) there are also low- or no-cost Medi-Cal attorneys who can help.

Good luck! Survivor of Medi-Cal hell

Urologist who accepts Medicaid for Paralyzed Friend

April 2005

Do you know a UROLOGIST who accepts Medicaid or who provides pro-bono services to the handicapped? A friend recently became paralyzed from the waist down. He's a young man and has limited financial means and he can't locate a urologist who accepts Medicaid. thanks so much

Your friend would likely need to go to the county hospital in his area; they generally have specialty clinics, like urology. At San Francisco General Hospital, if the patients needs can not be met by the specialist there, the patient is usually referred on to UCSF; so that might be another option for your friend. eve


(from Seeking Affordable Pediatrician (No Health Insurance )

There are alternatives to Medi-Cal in CA - There are over 50 health care plans available through the Healthy Families program and all are very low cost for low-income families. Ask the Health Dept about enrollment information.

Please call Healthy Families at 1-888-439-4741 immediately! This is a wonderful state and federally-funded program aimed at getting low-income kids all the health insurance they need. They target children from families who are low income - but not low income enough to be eligible for Medi-Cal. If you're eligible for the program, you get to pick your pediatrician, and your kids also get dental and optical insurance. My kids are far better insured than I am. This program has been a lifesaver for us while my husband's in grad school. Good luck Julie

From this very Listserv I found information about Healthy Families, an amazingly under promoted program in California that so many families with uninsured children qualify for. It provides health coverage (you choose the company) for children at very low, sliding scale rates. It is aimed at families that make too much for Medical, and are within 200% of poverty level (used to be 150%). I believe that this, in addition to Medical, would cover so many grad students still paying for Blue Cross or the even more expensive coverage the University offers. The application is tedious, but well worth it if you meet qualifications. Check the website. Eric

There are many sites and individuals certified to register kids for the Healthy Families program throughout Alameda County. A contact person for the Healthy Families program at UC Berkeley is Natalie Robinson. She is certified to help people get registered for Healthy Families and can assist generally in going through the process, answer questions, etc. Lea

One place that you can obtain more information/sign-up for the healthy families initiative is at the:

Bay Area Black Consortium for Quality Health Care
1440 Broadway, Suite 209
Oakland, CA 94612
(510) 763-1872