California Health Services FAQs

Read this page to find answers to questions related to health services in California. You will find information about specific healthcare programs like Medi-Cal, Medicare, PACT and the Affordable Healthcare Act as well as different situations within them. For comprehensive information about California health services, download our state guide.

Do I need to sign up for Medicare Part B if I have Veterans’ Benefits?

In California, if you do not sign up for Medicare part B then you may have to pay a late enrollment penalty, even if you have veteran’s benefits. Signing up for Part B when you are first eligible may provide you with additional location options and services.

How can I unsubscribe from my Medicare Part B plan in California?

You may opt out of Part B if you want to, but this is a serious decision to make. Before you decide, you may want to discuss your options with a California Social Security representative. If you do eventually decide to withdraw from the plan, the representative will help you complete the necessary form (CMS 1763). This particular form is not available online.

Under the Affordable Care Act, do I need to be on the same plan as my spouse?

No. In California, you and your spouse can be on separate plans, but remember than if you want to qualify for tax credit or subsidy, your eligibility will be based on your total household income. This means you spouse’s income will be included even if she is on a different health plan.

Why does my household income matter under the Affordable Care Act?

The federal government uses your family income (Modified Adjusted Gross Income) to calculate if you meet the requirements for the Affordable Care Act’s health insurance subsidy. Your household income is based on the mean household income for California.

Will I be paying more under the Affordable Care Act (ACA) if I am unhealthy?

As of 2014, the ACA prevents insurance companies from charging you a higher rate if you have a pre-existing health condition. Insurance companies can only base their prices on your age, where you live and the size of your family. In California, they cannot charge you a higher rate if you are a smoker.

Can I submit my Denti-Cal application package by fax?

You cannot submit your application by fax. All applications must have original signatures on them. Copied or faxed signatures will not be accepted.

Under Denti-Cal, can I get copies of my records and x-rays from my dentist?

You can request copies of your records and x-rays from your California dentist, but you may be charged a reasonable fee for them.

I have lost my Benefits Identification Card (BIC), what do I do?

You should contact your local California county social services office as soon as possible.

What is Estate Recovery in the state of California?

The Medi-Cal health care program is required to seek repayment from the estates of deceased Medi-Cal members, in certain circumstances. Medi-Cal will only seek repayment of benefits that were paid on or after the recipient’s 55th birthday, and only if they owned assets at the time of their death. If the decedent did not own assets, then nothing will be owed.

I heard that Medi-Cal will look into my belongings. Is that true?

Eligibility for Medi-Cal is determined by household income but, in some cases, your assets may be considered if you are not eligible based on income. You are allowed a certain asset limit. Some assets, such as your home and car are exempt.

Is Covered California a healthcare insurance company?

No, Covered California is a web portal where California residents can get private health insurance under the Patient Protection and Affordable Care Act. You can also use Covered California to see if you qualify for financial assistance from the federal government to help you pay monthly premiums

If I enroll in a health care plan with Covered California, when will I get my first bill?

This will depend on the type of plan you select, but typically you should be able to pay your first bill when you submit your online application for coverage. All subsequent bills should be paid directly to your plan providers, not through yourCovered California account.

Does Covered California offer health coverage for small businesses?

It does. To find out more information, visit the Covered California for Small Business page of the website. This page covers details about benefits for small businesses and their employees.

What happens if I choose not to get any health insurance?

Most Californians are required to have a health insurance plan under the Affordable Care Act. If you decide not to get any insurance, you will most likely have to pay a tax penalty for the period you were uninsured.

What is Presumptive Eligibility for Pregnant Women?

The Presumptive Eligibility for Pregnant Women (PEPW) program permits certain qualifying health care providers to allow immediate, temporary Medi-Cal coverage. This type of Medi-Cal is specifically to cover prescription medications and ambulatory prenatal care for certain conditions that are related to pregnancy. Eligible patients must be in receipt of a low income and have a Medi-Cal application pending.

What should I do if I receive Remittance Advice Details (RAD), which notes an overpayment?

You should correct the error by returning the overpayment by check. Submit it with a photocopy of the RAD to the Accounting Section at your local California county Department of Health Care Services (DHCS).

What is the Medicare waiting period?

Once you begin receiving your Social Security Disability Insurance (SSDI) payments, you will usually have to wait two years before getting Medicare unless you suffer from Lou Gehrig’s Disease or End Stage Renal Disease.

What Are the Available Health Services in California?

Low-cost, and even free health benefits are available to a large number of California residents, with some being offered to low-income applicants and others being offered to elderly or disabled individuals. However, before you can access these health services, you need to submit the appropriate application and prove that you meet the necessary qualifications. To learn all about the different health benefits you can receive in California and the application procedures that you must undergo to obtain these benefits, download our free comprehensive guide.

Who Is Eligible to Obtain California Health Benefits?

California’s health programs have various eligibility requirements that applicants must meet in order to successfully enroll. Income, age and other factors are all taken into consideration in the eligibility verification process. Find out which health benefits you qualify for here.