Public Programs That Cover Hospital Bills
If you are uninsured and have already gotten a hospital bill, you may be eligible for help with the bill from Medi-Cal or your county health program, even if you are working or own your own home.
Medi-Cal
Medi-Cal is health care coverage for qualifying persons who live in California and have low income and limited resources. Medi-Cal can cover unpaid hospital and other medical bills for up to three months before the date your application is received, as well as for bills after you apply.
Who can get Medi-Cal?
- Seniors 65 or older
- Children under 21
- Pregnant women
- Some adults between 21 and 65 years of age, if they are caring for minor children
- People who are blind or have a disabling condition
- Women who have been diagnosed with breast or cervical cancer
- People with tuberculosis
- People who need dialysis
- People in nursing homes
Income and property limits are different depending on family size and eligibility category. If you are in one of the groups listed above and have a hospital bill you cannot pay, you should apply for Medi-Cal even if you think you have too much money.
There are Medi-Cal programs for pregnant women and children ages 0-19 that do not count assets and resources. For these programs it does not matter if you own property or have money in the bank.
Assets are things you and your family own and could use to pay medical bills, such as savings accounts, retirement accounts, vehicles, etc. Some of your personal assets are not considered when determining whether or not you qualify for Medi-Cal coverage. For example, assets that do not count are: your primary home, one vehicle, household goods and personal belongings, a life insurance policy with a face value of $1500 per person, a pre-paid burial plan (unlimited if irrevocable and up to $1500 if revocable) and a burial plot. In most cases, Medi-Cal allows you to keep only $2,000 in assets as an individual, or $3,000 in assets as a couple. However, some assets can be waived in certain circumstances; ask your county Medi-Cal office about the Medi-Cal Asset Waiver program.
How do I apply for Medi-Cal?
You do not have to go to the Social Services office to apply for Medi-Cal. You can download a Medi-Cal Application Form here, have one mailed to you by calling your county social services office, or get one from the hospital. You can return your application by mail or in person to the nearest social services office in your county. Social Services offices go by different names in different counties and may be called welfare offices, family resource centers, or other names. If you need help filling out the forms, call your county social services agency. If you do not have all the documents requested on the application, or are not sure what you need, send what you have. You can send the rest later.
Keep a photocopy of your application and all supporting documents.
If you are determined eligible, Medi-Cal can pay hospitals and other medical bills incurred up to three months prior to the date of your application, so it is important to apply as soon as possible after getting your hospital bill.
How long does it take Medi-Cal to decide eligibility?
Once you send your application to your county Social Services agency, in person or by mail, the agency is supposed to determine your eligibility for Medi-Cal within 45 days and tell you in writing of that decision. In practice, it may take longer. It can be helpful for you to call your eligibility worker once in a while to check on the progress of your application, and to make sure s/he has all the information s/he needs. Children who apply by sending in the special joint Medi-Cal/Healthy Families mail-in application can get their Medi-Cal even faster, usually within 10 days. Children who apply through the Child Health Disability Prevention (CHDP)_Gateway program can get Medi-Cal right away. There are other ways to get Medi-Cal faster using electronic applications or using information in your Food Stamps or School Lunch applications. Talk to someone at your local legal aid office or Health Consumer Center to find out if any of these faster ways work for you.
If you need Medi-Cal to get continued treatment for a severe illness or impairment, where lack of treatment will kill or disable you, you should ask your caseworker for Presumptive Disability. Presumptive Disability allows you to get Medi-Cal as a disabled person while waiting for a final determination of disability.
If you have done everything you can, and your caseworker cannot answer or resolve your questions, ask to speak to a supervisor at the Social Services agency, and ask the supervisor to help. If you are unsuccessful or are denied Medi-Cal and think you should get it (or are uncertain), contact your Health Consumer Center for assistance.
County Health Coverage Programs
If you are uninsured, low income and not eligible for Medi-Cal, you may be eligible for help with a hospital bill from your county’s Medically Indigent Services Program (MISP). MISP goes by different names in different counties.
Counties can decide who is eligible for MISP programs, and at what income levels, so you must contact your county social services agency to find out if you are eligible and if the program will cover a hospital bill you have already received.
When last surveyed by Health Access in 2006, county income eligibility for MISP programs varied from a low of 90% FPL in Kern to a high of 500% FPL in San Francisco. Ongoing cuts to state and local health budgets may have reduced eligibility levels since then.
24 California counties have their own country-run MISP programs. The remaining 34 counties run a different program called CMSP (County Medical Services Program), which covers eligible people up to 2 times FPL and may require a monthly share of cost. In these 34 counties, you must apply in the month you receive services in order for your bill to be covered. People who do not qualify to get an existing hospital bill covered by CMSP may still qualify for health coverage into the future.
If you are uninsured and are not eligible for Medi-Cal, you should apply for your county health coverage program to help with future health care bills, even if it will not cover bills you already have. If you have low income and are denied coverage by your county, contact your local Health Consumer Center for assistance.
There are Medi-Cal programs for pregnant women and children ages 0-19 that do not count assets and resources. For these programs it does not matter if you own property or have money in the bank.