Next Steps: SB 75

Posted: June 16, 2016
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image from The California Endowment

Pursuant to Senate Bill (SB) 75, individuals under age 19, up to 266 percent of the federal poverty level (FPL), who do not have, or are unable to establish, satisfactory immigration status, are now eligible for full scope Medi-Cal benefits. The necessary system updates in CalHEERS and the State Automated Welfare Systems (SAWS) were completed on time and the official implementation of SB 75 began as scheduled on May 16. In LA County the Department of Public and Social Services (DPSS) transitioned children from restricted scope to full scope in a series of batch transactions the week of May 16. Cases that did not transition successfully will be verified manually by DPSS staff. DPSS aims to complete the manual transition of remaining cases by the end of June. Medi-Cal effective date will be May 1 for all of these children, regardless of whether they transitioned in May or June.

CCALAC has compiled resources that enrollment staff and families can use to help answer questions about this transition.

Medi-Cal for Children Covers:

  • Preventive Services, vaccines and wellness visits
  • Doctor visits
  • Emergency Services
  • Hospitalization
  • Prescription Drugs
  • Speciality care and prescription drugs
  • Eye exams and glasses
  • Dental Services.

Qualifying for Medi-Cal

To qualify for Medi-Cal, a household must not exceed a certain amount, depending on how many people are in the immediate house (e.g. children, spouses). Medi-Cal will be available to your family at free or no cost. For those families who must pay, the monthly premiums will are $13 per child however a family will currently pay no more than $39 per month for all their children.

Family of 4: $64,505 annual income ($5,375 per month)
Family of 5: $83,730 annual income ($6,978 per month)
Family of 6: $86,637 annual income ($7,220 per month)

Next Steps for SB 75 Enrollment

What to bring when enrolling:

  • Proof of identity (driver’s license or photo ID)
  • Proof of income (current pay stub or bank statement)
  • Child’s Birth Certificate or Legal Residence Card
  • Proof of Address (PG&E, cable or phone bill)
  • Previous Medi-Cal Card, if applicable

Note: Not all items may be required for enrollment assistance.

How It Looks

SB 75 Flow Chart

Click here to download PDF version

Client Information is Confidential

Any personal information shared when enrolling children into full scope Medi-Cal is confidential; it will never be shared with immigration enforcement. Unless a parent is in long-term care, Medi-Cal coverage does not constitute “public charge” that could affect immigration statuses.

Information provided on Medi-Cal applications is confidential and can only be used to determine eligibility (unless there is fraud on the application).

  • California Welfare & Institutions Code Section 14100.2 states that information provided on Medi-Cal applications is confidential and can only be used in the administration of the Medi-Cal program
  • Immigration and Customs Enforcement (ICE) published a memo stating that it would not use information from health insurance applications in immigration enforcement
  • Longstanding federal guidance provides that states cannot ask for the immigration status of non-applicants applying for Medicaid (Medi-Cal) for eligible family members
  • Also, using Medi-Cal will not cause your child to be considered a public charge (hurt their ability to become a permanent resident)
    • Exception: institutionalization for long-term care at government expense

Tools for SB 75/Health4All Kids Implementation

The following are materials and resources to support enrollers and other clinic staff with the implementation of the expansion of Medi-Cal to all eligible children, regardless of immigration status.

The information from this page was adapted from materials provided by The California Endowment (TCE). TCE’s Health4AllTeam has launched a one-stop collateral ordering website for partners to request #Health4All educational and promotional materials. Click here to visit the site and place your order.