Things I Wish I Knew (before applying for Medi-Cal)

Hi, all!

I wanted to write a post about my experience with Medi-Cal, the generous program of California state for people with low or no income who need health insurance. Starting a new business after leaving my job meant that I wasn’t going to have any employer-provided insurance, nor steady income to purchase my own (it would be about $500/month).

So, I started the process in December, thinking, “This’ll be straight forward.” HA! Famous last words… I almost immediately discovered how even the simplest step bred confusion in me. Here is what I learned, ordered loosely by importance and/or chronology.

(1) It’s going to take a minimum of two months, so start at least two months before you anticipate losing coverage.

I thought that, like employer-provided coverage, I would sign up and it would be available starting the next month… Wow, did I not understand the number of organizations involved in providing me coverage: Covered California → Medi-Cal → Health Care Options → Santa Clara Family Health Plan → Kaiser.

That’s a LOT of intercommunication, time, people, and steps.

(2) When asked for your income, if it’s ZERO, put 0.

I spent a lot of time trying to anticipate what my potential income would be. The truth is, of course, that I had no way of knowing. I kept seeing requests for estimates, and being a good test-taker, I wanted to answer the question. Once I got over that, I was confronted by requests for proof of income…

How can I prove that I have no income?

I finally used the chat feature on the Health Care Options website and talked with someone who told me that someone from Medi-Cal would reach out to confirm my information. The wait was INTERMINABLE… I like fast answers. Waiting for someone to call me was like being told, “You may have done this completely wrong, but you’ll have to see whether or not we notice in order to call you to let you know. There’s nothing you can do in the meantime. Good luck!”

Ultimately, I did get a phone call, and everything was handled easily.

(3) Every step takes 7 to 10 business days (so, two weeks for normal people).

This included the call from the Medi-Cal office. *deep inhale* *slow exhale* Once the process got going, it felt like a lot of “Hurry up and wait,” but really, it was just waiting for each department to process the information provided by the last, which required input from me each time.

I would say there will be a minimum of four steps, based on my experience.

(4) Call volume varies wildly throughout the day. Aim for off-peak times, but be prepared to be on hold for a minimum of 30 minutes.

I just got off the phone with Kaiser. At 11am, I had a 45 minute wait-time and a 2 minute conversation to complete the last step of my process. Yes, 45 minute wait for a 2 minute conversation. But it’s handled now! I have consistently had a 30 minute wait, regardless of when I call any of the organizations involved.

I was also told to avoid contacting departments on the first of the month… That’s when the crush of panicked people are calling in…

(5) Choosing Kaiser as your provider adds an additional month to the process.

I had an effective membership of March 1 through Santa Clara Family Health Plan. I thought that meant I would be a Kaiser member immediately. NOPE! That just meant that I could then apply to have Kaiser as my provider. I’ve been a Kaiser member for about 20 years. I really didn’t want to switch providers. I’m very fortunate that Kaiser accepts recent members (within 6 months) into their Medi-Cal program. They don’t accept new members that way, so make sure you plan accordingly. I will be active once again with Kaiser on April 1.

(6) Remember to be grateful (this is an amazing service by the state, and the people you talk with work hard to support us)!

They really do want to help! I have received calls from each organization when I anticipated having to call them or send them something by mail. Everyone tried to make the process as smooth as possible, even though it wasn’t (from my super privileged, “Why doesn’t everything work they way I want it to?!” perspective). Imagine how many desperate and/or angry people they deal with each day. Now imagine they got into this work because of their bleeding hearts… Yeah — OUCH!

At the end of the day, I am so fortunate to be able to be a part of this system that does its best to look out for my health.
So that’s that. Good luck to anyone applying for health care or transitioning from one provider to the next!

– Ryan

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