The following describes the State’s Medicaid program:
Name of Administering State Agency
Department of Health Care Services, Medi-Cal
Medicaid (Medi-Cal) Determinations
SSA makes determinations for SSI recipients and recipients of mandatory minimum and
optional State supplementary payments. The State makes determinations for all other
Additional Medicaid (Medi-Cal) Questions
SSA obtains answers to the question regarding third party coverage on the SSI application
and at all redeterminations.
SSA does not obtain answers to the question regarding unpaid medical expenses. (See
“Medicaid (Medi-Cal) Referrals” below.)
Field Office Instructions
Provide the following information to the SSI claimants:
Their SSI applications serve also as applications for Medicaid;
They will receive notice regarding their Medicaid eligibility from the State; and
A denial of their SSI claim does not necessarily preclude Medicaid eligibility if
they can meet the requirements of any Medicaid coverage group.
Medicaid (Medi-Cal) Referrals
While SSA is not required to ask the question regarding unpaid medical expenses on
behalf of the State, SSA should tell claimants that the Medicaid (Medi-Cal) program
may pay for unpaid medical expenses and refer them to the Medicaid (Medi-Cal) office.
When SSA does not make determinations of eligibility for Medicaid, refer those SSI
claimants to the Department of Health Care Services office for determination of eligibility
for Medicaid (Medi-Cal). Refer to regional supplements for any additional referral