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Frequently Asked Questions

Thanks to the Affordable Care Act, you get FREE Medi-Cal coverage in California if you were in foster care in any state at age 18 or older.

You qualify if you:

  • Were in foster care in ANY state on your 18th birthday or later,
  • Live in California now,
  • And are younger than 26

Have more questions? We have answers! Here are answers to common questions you may have about Medi-Cal coverage for former foster youth.

General Questions

Eligibility Questions

Sign-up Questions

Need Help?

Answers

Q: How does the Affordable Care Act (ACA) help former foster youth?

A: The ACA requires states to provide young people under 26 with free health care if they were in foster care at age 18 or older.

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Q: I already have health insurance through my school or work. Why should I sign up for the Medi-Cal program for former foster youth?

A: The Medi-Cal program for former foster youth provides you with certain benefits that you may not receive with your current insurance. Some benefits include:

  1. It’s free. You pay $0 for your insurance regardless of how much money you make.
  2. You can keep your Medi-Cal coverage until age 26 even if you start earning more money, change jobs, or leave school.
  3. You can sign up for fee-for-service Medi-Cal coverage, which means that you can go to any doctor, therapist, hospital, or dentist that accepts Medi-Cal. This means you have choices about where to go for health care. This also means you won’t have to change your health care plan when you move.
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Q: I already have Medi-Cal. Should I ask to be moved into the Medi-Cal program for former foster youth?

A: The Medi-Cal coverage available to former foster youth includes certain benefits that are not available to people enrolled in Medi-Cal based on their income. For example, if you are enrolled in the Medi-Cal program for former foster youth, you stay covered until your 26th birthday even if your income changes. As a former foster youth, you also have the option to choose fee-for-service coverage. This means you can go to any doctor, dentist, hospital or therapist that takes Medi-Cal, giving you choices about where to go and who to see for your health care.

If you are not in the Medi-Cal program for former foster youth, you can ask the county to move you into this program. You do not need to fill out a new application. Former foster youth should be assigned the ‘4M’ aid code.

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Q: What is fee-for-service Medi-Cal coverage?

A: There are two types of Medi-Cal coverage: fee-for-service and managed care. With fee-for-service Medi-Cal coverage, you do not have to sign up for a health plan. This means you can go to any doctor, therapist, hospital, or dentist that accepts Medi-Cal. With managed care Medi-Cal coverage, you must choose a health plan and you can only go to the doctors and providers that are in your health plan.

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Q: What’s covered?

A: Medi-Cal coverage for former foster youth includes the following:

  • Medical care
  • Vision exams (contact lenses and glasses are not covered for youth 21 or older)
  • Substance abuse treatment
  • Mental health services (including counseling)
  • Dental care (braces are not covered for youth 21 or older)

Former foster youth under 21 qualify for some extra benefits and services that youth 21 and older do not receive. For example, former foster youth under 21 receive additional dental services (such as braces) and vision services (such as contact lenses and glasses).

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Q: I am in foster care right now. Do I need to reapply for Medi-Cal when I leave foster care?

A: NO. If you leave foster care at age 18 or older after January 1, 2014, you do not need to reapply for Medi-Cal. You will be automatically moved into the Medi-Cal program for former foster youth when you leave care and will stay covered until age 26.

If you left foster care before January 1, 2014, and do not have Medi-Cal right now, you can sign up using a simple, one-page application for former foster youth (called the MC 250A). Most counties have a specific phone number, office, or staff to help former foster youth enroll. Click here for info on how to sign up in your county.

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Q: I just left foster care and want to make sure I am now in the Medi-Cal program for former foster youth. What do I do?

A: Contact your Medi-Cal worker or county social service office and ask if you are in the Medi-Cal program for former foster youth. Former foster youth should be assigned the ‘4M’ aid code. If you are not in the Medi-Cal program for former foster youth, you can ask the county to move you into this program.

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Q: If I move to a new county, do I need to reapply for Medi-Cal?

A: No, you do not need to reapply. Be sure to tell your Medi-Cal worker when you move. Your worker will update your address to make sure you do not have any problems seeing a doctor.

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Q: Do I qualify for free health care up to age 26 if I move to another state?

A: It depends on the rules in the state where you move. States must give Medicaid coverage (called Medi-Cal in California) up to age 26 to young adults who were in foster care in their own state. But states get to choose whether to cover young adults who were in foster care in another state. Right now, only 13 states have decided to cover former foster youth from other states. These states have decided to cover out-of-state former foster youth: California, Georgia, Kentucky, Louisiana, Massachusetts, Michigan, Montana, New York, New Mexico, Pennsylvania, South Dakota, Wisconsin, and Virginia. If you move to a state that does not give Medicaid to young adults who were in foster care in another state, you may still qualify for Medicaid based on your income or another reason, such as a disability. If you qualify for Medicaid in your new state, you get preventative and emergency care in your new state.

The Juvenile Law Center has state-by-state information about Medicaid coverage for former foster youth and how to sign up. This resource is helpful if you are considering moving outside of California: http://jlc.org/coveredtil26pa . Have more questions about Medi-Cal for former foster youth and out-of-state coverage? Email coveredtil26@childrennow.org

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Q: What happens to my Medi-Cal coverage if I am attending school in another state?

A: You have two options.

Option 1: If you are temporarily moving to another state, you can choose to keep your Medi-Cal coverage. You must let your Medi-Cal worker know that you plan to come back to California. Medi-Cal coverage will only cover emergency services while you are in another state. When you are in California, for example during a school break, your Medi-Cal will cover preventative and emergency care.

Option 2: You can discontinue your Medi-Cal and apply for Medicaid in your new state. You will need to check the Medicaid rules in your new state to see if you qualify for Medicaid there. States must give Medicaid coverage (called Medi-Cal in California) up to age 26 to young adults who were in foster care in their own state. Right now, only 13 states have decided to cover former foster youth from other states. These states have decided to cover out-of-state former foster youth: California, Georgia, Kentucky, Louisiana, Massachusetts, Michigan, Montana, New York, New Mexico, Pennsylvania, South Dakota, Wisconsin, and Virginia.

If you move to a state that does not give Medicaid to former foster youth from another state, you may still qualify for Medicaid based on income or another reason. If you qualify for Medicaid in your new state, you get preventative and emergency care in your new state.

The Juvenile Law Center has information on how to apply for Medicaid coverage for former foster youth in other states. This resource is helpful if you are considering moving outside of California: http://jlc.org/coveredtil26pa . Have more questions about Medi-Cal for former foster youth and out-of-state coverage? Email coveredtil26@childrennow.org

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Q: Will I need a new Medi-Cal card when I leave foster care?

A: NO. You can continue to use the same Medi-Cal card (called a Benefits Identification Card or BIC) that you had while in foster care. If you lost or can’t find your card, you can ask the county to give you a new one.

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Q: What happens to my Medi-Cal when I turn 26?

A: The Medi-Cal program for former foster youth gives young adults free coverage up to age 26. Before your coverage through the Medi-Cal program for former foster youth can be terminated, the county must check to see if you can still qualify for Medi-Cal under a different program or for other affordable health programs.

There are different ways to qualify for Medi-Cal. If the county cannot determine whether you still qualify for Medi-Cal with the information they have, the county may send you paperwork or ask you for additional information to decide if you qualify for another program. If you are eligible for another program, the county will put you in that program. If the county decides that you are no longer eligible for Medi-Cal, you will get a Notice of Action and information about how to appeal if you disagree with the decision.

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Q: Does it matter how much money I make?

A: NO. As a former foster youth, you are eligible for free Medi-Cal coverage no matter how much money you make. When you go to sign up, be sure to say you were in foster care on your 18th birthday.

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Q: I was in foster care in another state, but I live in California now. Do I qualify for the Medi-Cal program for former foster youth?

A: YES. It doesn’t matter which state you were in foster care. If you were in foster care in ANY state at age 18 or older, currently live in California, and are younger than 26, then you qualify for free Medi-Cal coverage.

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Q: Do I qualify if I lived with a relative? Do I qualify if I lived in a group home or residential placement? Do I qualify if I lived in a transitional living program?

A: Youth in foster care live in lots of different types of placements. If you were in foster care at age 18, you qualify for Medi-Cal coverage regardless of what type of placement you lived in.  Probation youth who were in foster care at age 18 also qualify for this coverage. If you aren’t sure if you were in foster care at 18 or older, don’t worry you can still fill out the one-page application for former foster youth. The county where you apply for coverage will verify that you were in foster care at age 18.

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Q: Do probation youth qualify for the Medi-Cal program for former foster youth?

A: YES, probation youth who were in foster care at age 18 qualify for this coverage.

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Q: I was not staying in an approved foster care placement on my 18th birthday. Am I still eligible for this coverage?

A: If your foster care case was still open on your 18th birthday, you likely still qualify for this coverage. For information on how you can sign up in your county, click here.

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Q: Does my husband or wife automatically qualify for Medi-Cal coverage because I am a former foster youth?

A: NO. The Medi-Cal program for former foster youth only covers young people who were in foster care at age 18 or older.  But your husband or wife may qualify for Medi-Cal on another basis (for example, based on income or due to a disability). When you go to sign up for coverage for yourself, you can ask about health care options for your family. As a former foster youth, you can skip questions about your income on any applications that you fill out.  This is because you qualify for Medi-Cal benefits regardless of income. But if you are applying for coverage for your spouse, you should answer income questions in order to determine if your spouse qualifies for coverage based on your family’s income.

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Q: Do my children automatically qualify for Medi-Cal coverage because I am a former foster youth?

A: NO. Your children do not automatically qualify for Medi-Cal coverage because you are a former foster youth. But your children may qualify for Medi-Cal coverage based on other reasons (for example, based on your income or due to a disability). When you go to sign up for Medi-Cal coverage for yourself, you should also ask about and apply for health insurance for your children. As a former foster youth, you can skip questions about your income on any applications that you fill out.  This is because you qualify for Medi-Cal benefits regardless of income. But if you are applying for coverage for your children, you should answer income questions in order to determine if your children qualify for coverage based on your family’s income.

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Q: I turn 26 years old in 2 months, am I still eligible for this coverage?

A: If you were in foster care on your 18th birthday, you qualify for this coverage through the month of your 26th birthday. You can sign up now and receive free coverage until you turn 26. You will remain covered through the end of the month in which you turn 26. For example, if you turn 26 on March 10th, you will remain covered until March 31st.

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Q: I live in Santa Clara County now, but I was in foster care in San Francisco County. Is this a problem?

A: This is not a problem. You can apply for coverage in the county where you live currently.

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Q: I already have health insurance through my job. Can I still sign up for the Medi-Cal program for former foster youth?

A: YES, you can sign up for the Medi-Cal program for former foster youth even if you already have health insurance.

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Q: Do I need written documentation that I was in foster care at age 18 or later?

A: NO. You do not need to provide any written documentation that you were in foster care at age 18. But you must answer “YES” when asked if you were in foster care at age 18 or older.  If you were in foster care in another state at age 18, be sure to say which state you were in foster care. The county where you apply for coverage will verify that you were in foster care at age 18.

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Q: How can I sign up for the Medi-Cal program for former foster youth?

A: Visit our “How to Sign Up” page.

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Q: Is there a simple form that former foster youth can use to apply for Medi-Cal coverage?

A: YES, you can apply for coverage using a one-page application for former foster youth (called the MC 250A).

You can use this form if you apply through the county directly. Right now, if you try to apply for coverage online or through Covered California you will be given a much longer application to complete.

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Q: Can I skip any questions about my income when I fill out any forms or applications?

A: YES, you can skip income and tax questions because you qualify for free Medi-Cal coverage regardless of how much money you make. But you will need to answer these questions if you are also applying for coverage for a family member, such as a child or spouse. Your child and spouse are not automatically eligible for Medi-Cal coverage based on your former foster youth status, but they may qualify for benefits based on your family’s income or other reasons (for example, due to a disability or a pregnancy).

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Q: Can I sign-up for Medi-Cal directly through a county office?

A: YES, you can sign up directly through your local Medi-Cal office using a simple, one-page application for former foster youth (called the MC 250A). Bring this form with you when you go to sign up or ask for it when you go to your Medi-Cal office.  Here are a few tips about signing up through your county Medi-Cal office:

  • Be sure to say you are a former foster youth when you go to sign up.
  • Be sure to say if you were in foster care in another state so that the county will know which state to contact to verify that you were in foster care at 18 or older.
  • Remember, you DO NOT have to provide income information or proof that you were in foster care at age 18 or older.

Because this is a new law, some county workers may not know that former foster youth are eligible for Medi-Cal up to age 26. Click here for info and tips on what to say or do if a county worker doesn’t know about this Medi-Cal program or if you think the worker is giving you wrong information.

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Q: Do I have to apply through Covered California?

A: NO, you do NOT have to apply through Covered California. You can apply for the Medi-Cal program for former foster youth through the county directly. Right now, the BEST way for you to apply for Medi-Cal coverage for former foster youth is through the county. For info and tips on the best way to sign up in your county, click here.

WARNING: You will likely have problems signing up for the Medi-Cal program for former foster youth if you try calling the Covered California 1-800 number or applying online. For these reasons, former foster youth should apply for Medi-Cal directly through the county.

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Q: I’m not sure if I was in foster care on my 18th birthday. How do I find this out?

A: The Foster Care Ombudsman can look up whether you were in foster care in California at age 18. Call the Foster Care Ombudsman at 1-877-846-1602 or email: fosteryouthhelp@dss.ca.gov to find out if you were in foster care at age 18.

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