What is Medi-Cal? A Beginner's Guide

Last Updated: September 2026

What Is Medi-Cal? A Beginner’s Guide

If you live in California and need affordable health coverage, you may have heard about Medi-Cal. But what exactly is Medi-Cal, who can qualify, and what does it cover?

This beginner’s guide explains the basics of Medi-Cal, including eligibility, benefits, Managed Care, the Medi-Cal BIC card, how to apply, and what happens after you are approved.

Quick Answer:
Medi-Cal is California’s Medicaid program. It provides free or low-cost health coverage to eligible California residents.

1. What Is Medi-Cal?

Medi-Cal is California’s Medicaid program.

It is a public health coverage program that helps eligible California residents receive medical care at little or no cost.

Medi-Cal is administered by the California Department of Health Care Services (DHCS), while local county offices handle many eligibility and enrollment functions.

Medi-Cal is different from Medicare. Medi-Cal eligibility generally depends on factors such as income and eligibility category, while Medicare is primarily a federal health insurance program for people age 65 and older and certain younger people with disabilities or specific medical conditions.

2. Who Can Qualify for Medi-Cal?

Medi-Cal has several eligibility categories. Whether you qualify depends on your individual circumstances.

Factors that may affect eligibility include:

California residency
Household income
Age
Household and tax filing information
Pregnancy
Disability
Whether you receive Medicare
Assets for certain Non-MAGI Medi-Cal programs
Immigration status for certain types of coverage

Different Medi-Cal programs have different eligibility rules, so two people in the same household may qualify for different types of health coverage.

Important for 2026:
Some Medi-Cal eligibility rules changed in 2026. Eligibility can depend on your specific Medi-Cal category, so always check current rules before applying or renewing.

For a more detailed explanation of current income guidelines, see: 2026 Medi-Cal Income Limits by Household Size .

3. What Is MAGI Medi-Cal?

Many children, parents, caretakers, pregnant individuals, and adults under age 65 are evaluated under rules known as Modified Adjusted Gross Income (MAGI).

MAGI Medi-Cal generally uses federal tax-based household and income rules to determine eligibility.

For many applicants, income is therefore one of the most important factors in determining Medi-Cal eligibility.

However, not everyone is evaluated under MAGI rules.

4. What Is Non-MAGI Medi-Cal?

Medi-Cal also has programs that do not use the standard MAGI rules. These are commonly referred to as Non-MAGI Medi-Cal.

Non-MAGI programs may apply to certain people such as:

Adults age 65 or older
People with disabilities
People who need long-term care
Certain Medicare beneficiaries
Other individuals who qualify under special Medi-Cal programs

For some Non-MAGI Medi-Cal programs, both income and assets may be considered when determining eligibility.

5. What Does Medi-Cal Cover?

Medi-Cal provides a broad range of health care benefits. The exact services available can depend on your eligibility, health plan, medical needs, and other program rules.

Covered benefits may include:

Doctor visits
Hospital and clinic services
Emergency care
Prescription medications
Preventive care and checkups
Laboratory tests and imaging
Maternity and newborn care
Mental health services
Substance use disorder treatment
Physical and occupational therapy
Dental services
Vision services
Medical equipment and supplies
Transportation for certain covered medical services
Long-term care and certain in-home services for eligible members

Remember:
Not every service is automatically covered in every situation. Some services may require a referral, prior authorization, or proof that the service is medically necessary.

For a more detailed breakdown of Medi-Cal benefits, read: What Services Does Medi-Cal Cover?

6. How Much Does Medi-Cal Cost?

For many eligible Medi-Cal members, health coverage is available at no cost or low cost.

Depending on the Medi-Cal program and the member’s circumstances, there may be little or no monthly premium and little or no out-of-pocket cost for covered services.

However, costs and rules can vary by eligibility category and service, so members should verify their specific coverage.

7. Is Medi-Cal the Same as Covered California?

No. Medi-Cal and Covered California are related to health coverage in California, but they are not the same program.

Medi-Cal is California’s Medicaid program for eligible residents.

Covered California is California’s health insurance marketplace, where individuals and families can purchase private health insurance and may qualify for financial assistance to reduce the cost.

When you complete a health coverage application through Covered California, the information can also be used to determine whether you may qualify for Medi-Cal.

Example:
Members of the same family do not necessarily receive the same type of coverage. A child might qualify for Medi-Cal while the parents qualify for a Covered California health plan with financial assistance.

8. Is Medi-Cal the Same as Medicare?

No. Medi-Cal and Medicare are different programs.

Medicare is a federal health insurance program primarily for people age 65 or older and certain younger people who qualify because of disability or specific medical conditions.

Medi-Cal is California’s Medicaid program and is based on Medi-Cal eligibility requirements.

Some people qualify for both Medicare and Medi-Cal. These individuals are often called dual eligible members.

For people who have both programs, Medicare generally pays for Medicare-covered services first, and Medi-Cal may help with certain remaining costs and additional covered services, depending on eligibility.

9. What Is Medi-Cal Managed Care?

Most Medi-Cal members receive health care through a Medi-Cal Managed Care health plan.

A Medi-Cal health plan has a network of doctors, clinics, specialists, hospitals, and other health care providers.

Members generally choose or are assigned a Primary Care Provider (PCP), who helps provide routine care and coordinate other medical services.

Available Medi-Cal health plans depend on the county where you live.

If you need help finding a provider, see: How Can I Find a Doctor Who Accepts Medi-Cal?

10. What Is Fee-for-Service Medi-Cal?

Some Medi-Cal members receive services through Fee-for-Service (FFS) Medi-Cal, sometimes called Regular Medi-Cal.

With FFS Medi-Cal, members can receive covered services from enrolled Medi-Cal providers who accept Fee-for-Service Medi-Cal.

Some people may also have FFS Medi-Cal temporarily before enrolling in a Managed Care health plan, depending on their circumstances and county.

11. What Is the Medi-Cal BIC Card?

After you are approved for Medi-Cal, you receive a Benefits Identification Card (BIC).

The BIC identifies you as a Medi-Cal member and is used by health care providers to access information needed to provide and bill for Medi-Cal-covered services.

If you are enrolled in a Medi-Cal Managed Care plan, you may also receive a separate membership card from your health plan.

Keep Both Cards:
If you have a Medi-Cal Managed Care plan, keep both your Medi-Cal BIC and your health plan membership card. A medical office may ask to see one or both cards.

12. How Do You Apply for Medi-Cal?

You can apply for Medi-Cal at any time during the year. Unlike many private health insurance plans, you do not have to wait for an annual open enrollment period to apply for Medi-Cal.

Depending on your situation, you may apply:

Online
Through Covered California
Through your local county office
By phone
By mail
In person

Your application will be reviewed to determine which health coverage program you may qualify for.

13. What Happens After You Are Approved?

After Medi-Cal approval, you will generally receive information about your eligibility and coverage.

New Medi-Cal beneficiaries receive a Benefits Identification Card (BIC). Depending on where you live and your eligibility, you may also need to enroll in or be assigned to a Medi-Cal Managed Care health plan.

Once enrolled in a health plan, you can select or be assigned a Primary Care Provider and begin using your health plan’s network for covered services.

For the complete step-by-step process after approval, read: What Happens After I Am Approved for Medi-Cal?

14. Do You Have to Renew Medi-Cal?

Yes. Medi-Cal eligibility must be renewed periodically.

Sometimes the county can renew your Medi-Cal automatically using information already available. In other cases, you may receive a renewal form asking for additional information.

To help keep your Medi-Cal:

Keep your address and contact information current.
Open and read notices from your county.
Provide requested information by the deadline.
Complete your renewal when required.

Important:
Do not ignore Medi-Cal renewal notices. Missing a required renewal or failing to provide requested information can result in your coverage ending even if you might otherwise remain eligible.

15. Important Medi-Cal Changes for 2026

Medi-Cal rules can change from year to year. Changes may affect eligibility, renewals, immigration-related eligibility, assets for certain Medi-Cal categories, or covered benefits.

For a detailed explanation of important changes, see: 2026 Medi-Cal Changes Explained .

16. Key Takeaway

Medi-Cal is California’s Medicaid program and provides free or low-cost health coverage to eligible California residents.

It can cover a wide range of health services, including doctor visits, hospital care, prescriptions, preventive care, mental health services, dental and vision care, pregnancy care, and many other medically necessary services.

However, Medi-Cal is not one single eligibility category. Your income, age, household situation, pregnancy, disability, Medicare status, assets in certain programs, immigration status, and other factors can affect the type of Medi-Cal coverage you may receive.

If you think you may qualify, you can apply at any time during the year and let Medi-Cal or your county determine your eligibility.

Official Sources & Resources

Disclaimer: California Benefits Guide is an independent informational website and is not affiliated with or endorsed by the California Department of Health Care Services (DHCS), Covered California, a county Medi-Cal office, or any other government agency.

Medi-Cal eligibility rules, income limits, asset rules, immigration-related eligibility, benefits, health plans, and other program requirements may change. This article provides general information only and is not an official eligibility determination or legal advice. Always verify your individual eligibility and benefits with DHCS, Covered California, or your local county Medi-Cal office.

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