Medi-Cal Highlights

Medi-Cal is California's Medicaid program. It is a public health insurance program which provides health care services for low-income residents. Key facts when working with families include:
  1. All income-eligible children up to age 26, including undocumented children, can enroll in full scope Medi-Cal. This includes dental care, mental health, and other benefits. Children are income eligible if their family earns below 266% of the federal poverty level (FPL). Families will pay a small monthly premium if they have household incomes nearer to the limit, except for children ages 0-1, who do not have premiums at any qualifying income level. Check eligibility at https://benefitscal.com/​ or apply.coveredca.com/lw-shopandcompare.
  2. Parents and single adults under age 65 with incomes up to 138% of the Federal Poverty Level who are U.S. citizens or have certain immigration statuses are eligible for full-scope Medi-Cal coverage at no cost. Adults with incomes above this level qualify for subsidies through Covered California. For information on special circumstances, contact SLO County DSS.
  3. As of January 2026, undocumented adults and those with certain immigration statuses can keep their full-scope Medi-Cal if they already have it but cannot add Medi-Cal coverage due to an enrollment freeze unless they are pregnant. People with these statuses will lose dental benefits in July 2026 except for emergency dental care. They will remain eligible for emergency Medi-Cal services.
  4. Pregnancy coverage: Pregnant women can access Medi-Cal coverage at higher income levels and regardless of immigration status. See information below and learn more here: www.coveredca.com/individuals-and-families/getting-covered/pregnant-women.
  5. In San Luis Obispo County, families with Medi-Cal coverage become members of CenCal Health, the county's Medi-Cal managed care provider. CenCal Health sends parents information about selecting a primary care provider and other member benefits.
  6. If a child already has a family member enrolled in Medi-Cal, no new application is needed; families can contact the Department of Social Services to have other children in the family added.

Medi-Cal Enrollment

Parents can enroll their families online at 
https://benefitscal.com/​, or by visiting a SLO County Department of Social Services office: www.slocounty.ca.gov/Departments/Social-Services/Our-Locations.aspx

Medi-Cal Privacy

Immigrant families may be concerned about their Medi-Cal information being provided to the Federal government.

This fact sheet has information about data privacy and public programs to help families make informed decisions about their participation. 

It is also recommended that people talk to an immigration attorney if they have concerns about using Medi-Cal services. 

2026 Medi-Cal Changes for Adults with Certain Immigration Statuses

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2026 has two key changes to Medi-Cal for adults who are undocumented or have certain immigration statuses. For detailed information on who this applies to, click here.

1) Medi-Cal enrollment freeze. For 2026, there is currently a freeze on NEW enrollments to full-scope Medi-Cal for adults who are undocumented or have certain immigration statuses. Key points are:
  • If someone is already enrolled in Medi-Cal as of January 1, 2026, they will stay covered regardless of their immigration status as long as they complete their annual renewal.
  • If someone loses their Medi-Cal coverage, they will not be able to sign up again, except for emergency and pregnancy care.
  • If someone's coverage stops because of a late renewal or missing paperwork, they have 90 days to fix it and stay enrolled.
  • Income-eligible children and pregnant women can still enroll in full-scope Medi-Cal regardless of their immigration status. For pregnancy, the coverage is for the entire pregnancy and one year after the pregnancy ends.

2) Loss of Medi-Cal Dental coverage starting July 1, 2026 for adults who are undocumented or have certain immigration statuses. Even adults who keep their Medi-Cal during the enrollment freeze may lose their dental coverage depending on their immigration status. Key points are:
  • Dental coverage ends July 1, so people should use dental benefits now.
  • Emergency dental care will still be covered (extractions, infection, severe pain).
  • Children and pregnant women do not lose their benefits.
  • Starting October 1, the definition of who does NOT qualify for dental will expand, so people should check their status with their DSS worker and use their benefits now.

For questions, contact a local Social Services office: https://www.slocounty.ca.gov/Departments/Social-Services/Our-Locations.aspx

Pregnancy/Postpartum Medi-Cal for One Year After Last Day of Pregnancy

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Do you have clients who are pregnant or new moms and need health insurance? Medi-Cal and the Medi-Cal Access Program (MCAP) offer Medi-Cal health coverage for pregnant and postpartum women who do not have full insurance coverage. MCAP is for middle-income families who do not have health insurance and whose income is too high for no-cost Medi-Cal.
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Postpartum coverage extends for one year following the last day of pregnancy. Postpartum women can receive Medi-Cal services regardless of income changes after birth, citizenship, or immigration status. This includes postpartum depression services.
 
Please remind your clients of this important mental and physical health resource! Families can contact their local Department of Social Services office to learn more:  https://www.slocounty.ca.gov/Departments/Social-Services/Our-Locations.aspx

Medi-Cal Tips

Give it a try!
Not sure whether a client qualifies? Apply online at coveredca.com, go in person to SLO County DSS, or call Covered California at 1-800-300-1506 and Covered California will transfer the client to SLO County DSS if they qualify for Medi-Cal. Remember that for children's coverage, the income limit is higher than adults. For enrollment assistance resources, click here.

No Open Enrollment Period
There is no open enrollment period for Medi-Cal. Enrollment is ongoing, based on income. 

New Enrollees
When a person first enrolls in Medi-Cal, their medical coverage is "Fee-For-Service" through the State of California for the first month and until they receive their CenCal Health card. Once they have their CenCal Health card, they are on the CenCal Health managed care plan. Community Health Centers of the Central Coast (CHC) will accept both types of coverage, but some private doctors on the CenCal Health managed care plan may not accept Fee-For-Service Medi-Cal.

More Information
At SLO County DSS: https://www.slocounty.ca.gov/departments/social-services/medical-resources/services/medi-cal 

In Case of Emergency: Hospital Presumptive Eligibility (HPE) Program

The Hospital Presumptive Eligibility (HPE) program assists low-income, uninsured residents in accessing hospital services in an emergency through temporary access to full-scope Medi-Cal at no cost for up to two months. Eligibility is based on household size, income and state residency and is taken based on the applicant’s own self-attestation. U.S. citizenship is not required.

All San Luis Obispo County hospitals can submit applications for this emergency care. This means that the cost of an emergency room visit and related hospital stay can be covered by Medi-Cal even if the person lacks an immigration status to enroll in full-scope Medi-Cal.

For more information about the Hospital Presumptive Eligibility Program: www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/HospitalPE.aspx.

Medi-Cal Coverage and Care Providers Explained

Coverage (insurance): Medi-Cal members in San Luis Obispo County are enrolled in a managed care plan through CenCal Health. This means that they can see any doctor with whom CenCal Health contracts. Dental coverage is provided through the Medi-Cal Dental Program, a state network. Mental health coverage is provided by San Luis Obispo County Behavioral Health for more severe mental illness and by community providers contracted with CenCal Health for mild to moderate mental health issues.

Care (providers): For a list of Medi-Cal health care providers, contact CenCal Health or visit the CenCal Health provider directory. CenCal Health also provides care for mild to moderate mental health issues - learn more here. For more severe mental health issues, call the County Mental Health intake number at (800) 838-1381. The SLO County Oral Health program provides a list of local Medi-Cal Dental Program providers - visit this link to view the list. Or find Medi-Cal Dental Program providers by searching the state directory: ​dental.dhcs.ca.gov/find-a-dentist/home.