Health Coverage
Are you a Current Medi-Cal Beneficiary?
During the COVID-19 Public Health Emergency (PHE), Medi-Cal beneficiaries stayed enrolled in the Medi-Cal program. Beginning July 2023, Medi-Cal redeterminations resumed. If your contact information has changed, please contact our office at (530) 541-2700 to update your information. This will assist in preventing a loss of coverage due to returned mail.
The three options available to County individual are Medi-Cal, CMSP and Covered California. They are explained below.
Medi-Cal Information
What is Medi-Cal?
Medi-Cal offers free or low-cost health coverage for California residents who meet eligibility requirements. Most applicants who apply either through Covered California or directly with the County and are enrolled in Medi-Cal will receive care through managed health plans.
Medi-Cal has always covered low-income children, pregnant women and families. On January 1, 2014 California expanded Medi-Cal eligibility to include low-income adults. When you complete a Covered California application, your eligibility for Medi-Cal will automatically be determined. You can apply for Medi-Cal benefits regardless of your sex, race, religion, color, national origin, sexual orientation, marital status, age, disability, or veteran status.
Medi-Cal (called Medicaid in other states) provides quality health care coverage to qualifying residents of California with income and resources below established limits.
Who Can Get Medi-Cal?
There are multiple ways that an individual can get Medi-Cal. If an individual doesn’t meet the eligibility requirements under one program, they can be evaluated under other programs. When evaluated for eligibility to Medi-Cal, any or all of the following will be used to determine what program an individual is eligible to receive:
- Income based rules
- Adults ages 19-64 who’s household income is below 138% of the Federal Poverty Level may be eligible
- Children under the age of 19 and pregnant women have higher income limits
- Individuals over the income limits but with resources below the federal limits may still be eligible if any of the following applies
- The household is a family with a child below the age of 21
- The individual is blind or disabled
- Individuals receiving Medicare
- Can receive assistance in covering expenses not included by Medicare if all eligibility requirements are met
- Children under the age of 21
- Low-income families with children
- Individuals over the age of 65
- Persons who are blind or disabled or in a nursing home
- Pregnant women
What Services Does Medi-Cal Cover?
If you have questions about what is covered by Medi-Cal please contact the Medi-Cal Benefits Division at 1-800-541-5555. Outside of California please call 916-636-1980.
If you have questions regarding a specific service and you have Medi-Cal managed by Partnership Health, please call their Member Services Department at 800-863-4155.
How to Apply
- You can apply for benefits online using BenefitsCal or at CoveredCA.com
- By calling the Covered California at 1-800-300-1506
- You may mail your application to Siskiyou County Health and Human Services Agency at 818 S. Main Street, Yreka, CA 96097
- You may fax your application to Siskiyou County Health and Human Services Agency at 530-841-2723
- You may apply in person at 818 South Main Street in Yreka.
- By calling Siskiyou County Health and Human Services Agency at 530-841-2700
How can I find more information about Medi-Cal
Learn more about Medi-Cal by visiting the Department of Health Care Services website.
Partnership Health Plan (PHC)
Partnership HealthPlan (PHC) is a Managed Care Health Organization that contracts with the State of California to ensure Medi-Cal recipients in Siskiyou County have access to quality medical care. PHC provides new members with a list of participating hospitals and physicians, from which new members are asked to choose a Primary Care Physician (PCP). The PCP is responsible for providing medical care to those members assigned to him/her. The PCP is also responsible for referring his/her patients to a specialist when there is a medical need.
PHC has a Member Services Department that is available Monday - Friday, 8:00 am - 5:00 pm. at 707-863-4120 or 800-863-4155. PHC also has a website (http://www.partnershiphp.org) that provides excellent information, including the following:
- Changing to a new primary care provider
- Getting bills for medical care
- Getting a new or replacement PHC ID card
- File an appeal or complaint about PHC, your medical care, or your medical provider
- Questions about PHC or the services PHC provides
- Problems getting a medical appointment
- Problems getting a prescription filled
- If you paid for medication and/or a co-pay
- Interpreting Services
Covered California Information
What is Covered California?
Beginning in October 2013, families or individuals who do not qualify for Medi-Cal, can now access quality affordable insurance through Covered California.
www.coveredca.com is a joint partnership between Covered California's™ and the California Department of Health Care Services (DHCS).
Covered California offers health insurance plans, which cannot be canceled or denied, at an affordable price. Californians can shop for the plans online or see if they are eligible for Medi-Cal, and Covered California will provide in-person and phone assistance for those who need it.
Marketplace Details
When you visit Covered California’s marketplace, you will be able to make apples-to-apples comparisons among different health insurance plans and choose the plan that best meets your needs and those of your family.
Covered California is the only place where you can access assistance in paying your insurance premium, offered by the federal government to reduce the cost of health insurance. If you qualify for premium assistance, this money will reduce what you pay for your insurance.
To reach a Service Center Representative, please call:
- Covered California Service Center Phone: 800-300-1506 TTY: 889-889-4500
Covered California's™ Small Business Health Options Program (SHOP) is a new, health insurance marketplace developed for businesses with one to 50 eligible employees (An eligible employee is an employee who works an average of 30 hours).
Business owners know that the ability to offer employees quality health insurance is a competitive advantage in the labor market. Health insurance through Covered California's SHOP gives you financial control of your business while allowing your employees to choose from a range of quality, affordable health plans.
There is no penalty for not enrolling in SHOP, and there is no additional fee for using a Certified Insurance Agent.
- For SHOP Certified Insurance Agent and Employer support, please call: 877-453-9198
CMSP Information
What is CMSP
The County Medical Services Program (CMSP) provides health coverage for Siskiyou County adults ages 21 through 64 who are not otherwise eligible to Medi-Cal benefits and are outside of the Covered California open enrollment period.
The County Medical Services Program (CMSP) provides health coverage for Siskiyou County adults ages 21 through 64 who have net non-exempt income at or below 200% of the federal poverty level and who are not eligible for Medi-Cal benefits.
What Services Does CMSP Cover?
- Click for a detailed lists of CMSP Benefits
- Medical benefits
- Dental benefits
- Vision benefits
How to Apply
- You can apply for benefits online using BenefitsCal or at CoveredCA.com (selecting Medi-Cal)
- By calling Covered California at 1-800-300-1506
- You may mail your application to Siskiyou County Health and Human Services Agency at 818 S. Main Street, Yreka, CA 96097
- You may fax your application to Siskiyou County Health and Human Services Agency at 530-841-2723
- You may apply in person at 818 South Main Street in Yreka.
- By calling Siskiyou County Health and Human Services Agency at 530-841-2700