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Funding and Eligibility Information
Medi-Cal is a state and federal funded program which pays for medically necessary treatment services, medicines, durable medical equipment and medical supplies needed by people with disabilities who satisfy income and resource guidelines. Medically necessary services include rehabilitation and other services needed to attain or retain the capability for normal activity, independence or self-care. Medically necessary is defined:
"Services, medicines, supplies and devices necessary to protect life, to prevent a significant illness or disability, or to alleviate severe pain."
Recipients of Supplemental Security Income (SSI), California Temporary Assistance Program (CalTAP) and In-Home Supportive Services (IHSS) automatically receive Medi-Cal. Others may receive Medi-Cal under the Medically Needy and Medically Indigent Child Medi-Cal programs, although there may be a monthly charge for services.
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)
The EPSDT program is a federal Medicaid obligation imposed on the states as a condition of receiving federal Medicaid funds. In California, for all Medi-Cal eligible persons under age 21 years, the State must provide screening for mental, physical, and developmental health needs, including vision, hearing and dental. Screening is scheduled on a regular basis according to the child's age, and eligible persons must be allowed a screen at any time a physical or mental illness or condition is suspected. Under the EPSDT program, eligible persons are entitled to an expanded scope of benefits.
For more information regarding Medi-Cal and EPSDT benefits and eligibility, contact your local county social services office.