¡Para Español, pulse aquí!

Don’t Lose Your Benefits: Ensuring Healthcare Access for Children

The Medi-Cal program provides essential healthcare coverage for individuals and families in need. While eligibility requirements typically involve the qualification of the parents or guardians, it’s important to note that children under the age of 19 may still be eligible for Medi-Cal coverage, even if their parents do not meet the requirements. In this blog post, we will explore the special rules put in place during the COVID-19 Public Health Emergency (PHE) that allow children to access and maintain their Medi-Cal benefits, regardless of their parents’ qualification.


The Impact of the COVID-19 PHE

In response to the outbreak of COVID-19, the U.S. Department of Health and Human Services (HHS) declared a PHE in January 2020. This declaration brought about temporary changes to the Medi-Cal program, ensuring that more people could access and retain their benefits during these challenging times. Prior to the PHE, California would review beneficiaries’ information and renew their participation in Medi-Cal if they still qualified. However, when the continuous coverage requirement expires at the end of the PHE, a full redetermination process will be conducted for all beneficiaries who would have otherwise been subject to redetermination.


Child Eligibility Beyond Parental Qualification

One of the key aspects to note is that even if parents do not qualify for benefits, their children are still eligible for Medi-Cal coverage in most cases. In California, children under the age of 19 are eligible for full-scope Medi-Cal benefits, regardless of their parent’s immigration status or eligibility, as long as they meet the necessary requirements. This means that regardless of the parent’s situation, children can still receive the vital healthcare they need through the Medi-Cal program.


Phase II Initiatives for Beneficiary Awareness

The California Department of Health Care Services (DHCS) has implemented a two-phase approach to ensure beneficiaries are aware of the need to requalify for Medi-Cal. Currently in Phase II, the state is projected to have an auto-renewal rate of 25%, with an estimated loss of coverage for approximately two to three million individuals. The Centers for Medicare and Medicaid Services (CMS) has allowed a total of 14 months to resume normal eligibility redetermination, giving beneficiaries ample time to requalify for Medi-Cal and avoid a disruption in coverage.

It’s crucial for parents to understand that even if they do not qualify for Medi-Cal benefits, their children may still be eligible for coverage. The impact of the COVID-19 PHE has brought about temporary changes to the continuous coverage requirement, allowing children under the age of 19 to receive full-scope Medi-Cal benefits based on their own eligibility. As California moves forward with the redetermination process, it’s important for beneficiaries to stay informed and take the necessary steps to ensure uninterrupted healthcare coverage for themselves and their children.

For more information on eligibility requirements and the renewal process, we encourage you to visit the official website of the California Department of Health Care Services (DHCS) or contact your local county social services office.

View Your Benefits! 

Book your appointment with us today!