Transitions Clinic Network (TCN) hosts a monthly reentry health-focused Frequently Asked Questions (FAQ) column. This column is a space where we can answer questions regarding healthcare in reentry. Our goal is to provide information and empower individuals to prepare them for healthy reentry. For this column, we will focus on Medi-Cal, the public health insurance system in California.
We’re thrilled to be able to communicate with the incarcerated community. In future columns, we will be talking about many different topics, such as health insurance, MAT (medication-assisted treatment), prevention and treatment for Hepatitis C and HIV, defining and finding gender-affirming care, managing chronic conditions, and much more.
What is Medi-Cal? Medi-Cal is health insurance for people in the community who make less than $17,775 taxed income per year. Medi-Cal is California’s version of Medicaid, which is the nation’s public health insurance program for people with low-income. Almost everyone who is coming home from incarceration is eligible for Medi-Cal. You may not be eligible for Medi-Cal if you are covered under another health insurance plan, such as one through your family or spouse.
Why should I care about health insurance? While you are incarcerated at CDCR, the State pays for your health care services. In the community, when you see a doctor or get medications, payment is required. Health insurance, such as Medi-Cal, helps pay for these services.
What does Medi-Cal pay for? Medi-Cal covers “medically necessary” care. This includes doctor and dentist appointments, prescription drugs, vision care, mental health care, and substance use disorder and/or alcohol
treatment. Many clinics in the community accept Medi-Cal. You should ask if your doctor or clinic accepts Medi-Cal before getting care or you may get a bill.
Does Medi-Cal cover dental care? Denti-Cal is FREE insurance that pays for some dental services. It is available to
anyone who qualifies for Medi-Cal. Dental services are usually separate from medical services. You may need to go
to a different provider or clinic for dental services.
Medi-Care and Medi-Cal sound very similar. Are they the same thing? No. Medicare is health insurance. for people 65 and older or those who are on social security disability insurance (SSDI), regardless of income. Medi-Cal is health insurance for people who are low-income. You can be enrolled in both plans at the same time if you meet the criteria. This is called “dual eligibility”.
When is the best time to apply for Medi-Cal? Can I apply for Medi-Cal before I leave prison? You will need Medi-Cal when you’re home in the community and want medical services. The prison has staff who will help you apply 1-3
months before release. We’ll share more information about the Medi-Cal application process in the next month’s FAQ column.
Services that Medi-Cal pays for include:
• Emergency room visits
• Checkup or routine physical exam
• Substance use disorder and/or alcohol
treatment (including buprenorphine,
Methadone and Naltrexone)
• Mental health treatment
• Hepatitis C treatment
• HIV treatment
• Eye exams & glasses
• Prescription medications
• Lab work
Services that Medi-Cal does not pay for:
• Vitamins and supplements
• Over-the-counter medications
(medications you can buy on your own at
the store without a doctor’s prescription)
• Anything considered cosmetic instead of
“medically necessary”