News23ABC In-Depth


'Full scope' Medi-Cal benefits now available for people over the age of 50

Posted: 4:38 PM, May 04, 2022
Updated: 2022-05-04 21:26:16-04
Medi-Cal (FILE)

SACRAMENTO, Calif. (KERO) — As of this month, nearly 200,000 more people are now eligible for Medi-Cal coverage.

"Medi-Cal is California's Medicaid program. This is a public health insurance program that provides needed health care services for low-income individuals including families with children, seniors, persons with disabilities, foster care, pregnant women, and low-income people with specific diseases such as tuberculosis, breast cancer, or HIV/AIDS. Medi-Cal is financed equally by the state and federal government."

As a result of economic disparities, many people have had little or no access to health care which can have costly consequences regarding their quality of life, and their lifespans. But now, full health care coverage is now available to eligible people over the age of 50 regardless of immigration status.

Prior to this extension people with restrictive Medi-Cal were only eligible for emergency services. However, now with "full scope" Medi-Cal benefits, people are able to access other services such as dental and vision coverage.

René Mollow, the deputy director for health care benefits and eligibility with the California Department of Health Care Services adds that this expansion will help improve financial security for those who enroll and also give people who were previously enrolled with Medi-Cal a full scope of benefits. Previously those who are not U.S. Citizens were only eligible for emergency and pregnancy services.

“It's looking at providing comprehensive affordable health care services to these individuals who are residents and contribute to our economy on a regular basis," said Mollow. “That could include hospitalizations, preventative services, routine care that an individual may have a need for. It can include dental services, pharmacy services, so there’s a full scope of benefits that would be available to them.”

Nancy Duran Torres with Greater Bakersfield Legal Assistance tells 23ABC that this extension will help increase the overall health of those who might have previously run into barriers with medical treatment.

“There’s a lot of families that have mixed households where some individuals were eligible for full-scope medical benefits and others were only eligible for restrictive medical. I strongly suggest that those individuals that were previously not eligible for full-scope medical benefits contact their county worker. We do have a two plan system in place here Medi-Cal members are able to either enroll in kern family health care or health net.”

And although the extension was proposed in the governor’s budget for people over the age of 50, Mollow says that the state’s efforts to ensure quality health care for all don’t stop there.

“There is also in the government’s budget a future expansion that is envisioned for individuals 26 to 49 again with the goal of looking at coverage for all individuals in our state. These are just implemental steps that are taking us to get there.”

It is estimated that about 185,000 people will benefit from this health coverage extension and Mollow says there’s been a lot of outreach and educational work done on their end to inform as many people as possible.

“We send out letters to individuals who are currently enrolled in our program about this change in our coverage that would be forthcoming. We also work with key stakeholders.”

However, Torres adds this extension is important because it specifically aids populations most at risk.

For those who are 50 years old or older and are interested in enrolling in full-scope Medi-Cal benefits, you can apply by mail, in person, or online.

23ABC In-Depth

23ABC In-Depth: Medi-Cal Distribution

According to the Department of Health Care Services, a little less than half of all Medi-Cal recipients are Hispanic at 49.1-percent.

The second highest group of recipients on the list are white, at 17.4-percent. Following behind them are Asians or Pacific Islanders with a recipient rate of 9.5-percent.

At the bottom of the list with the lowest percentage of total Medi-Cal recipients are African-Americans at 7.1-percent.

What are the Medi-Cal Benefits?

Medi-Cal currently provides a core set of health benefits, including doctor visits, hospital care, immunization, pregnancy-related services and nursing home care. The Affordable Care Act ensures all Medi-Cal health plans offer what are known as Essential Health Benefits (EHB). These ten comprehensive services include the following categories:

  1. Outpatient (Ambulatory) services
  2. Emergency services 
  3. Hospitalization
  4. Maternity and Newborn care 
  5. Mental Health and Substance Use Disorder Services​
  6. Prescription Drugs
  7. Programs such as physical and occupational therapy (known as Rehabilitative & Habilitative Services) and devices
  8. Laboratory services
  9. Preventive and wellness services & chronic disease management
  10. Children’s (Pediatric) services, including oral and vision care.

Medi-Cal offers comprehensive preventative and restorative dental benefits to both children and adults.

Medi-Cal also offers mental health and substance use disorder services benefits.

You can learn more about services within each category on the Medi-Cal website.