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 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?
Until 2014, the only people who can get Medi-Cal are:
- 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, including:
- Women who have been diagnosed with breast or cervical cancer
- People with tuberculosis
- People who need dialysis
- People in nursing homes
If you do not fit any of these categories but are low-income, you may be eligible for coverage under your county's Low-Income Health Program (see below).
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, because income and property limits are different depending on family size and eligibility category.
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.
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 Low-Income Health Programs (LIHP)
If you are uninsured, low income and not eligible for Medi-Cal, you may be eligible for coverage and retroactive help with a hospital bill from your county’s Low-Income Health Program.
Counties can decide who is eligible for LIHP 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.