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Senate Bill 75 Expands Full Scope Medi-Cal Coverage for All Children

April 19, 2016

Effective no sooner than May 1, 2016, qualified children under 19 years of age, regardless of immigration status, will receive full-scope Medi-Cal coverage if they are otherwise eligible. These children currently have restricted-scope Medi-Cal. When their Medi-Cal coverage expands to full scope, they will be covered for both non-emergency and emergency medical services, dental care, vision benefits, mental health, and substance use disorder services.

There are two populations of children impacted by this change in Medi-Cal coverage:

  • Population 1: Children who are currently in restricted-scope Medi-Cal and whose coverage will expand to full scope no sooner than May 1, 2016.
  • Population 2: Newly eligible children who apply for Medi-Cal on or after May 1, 2016.

Most of these children must enroll into a Medi-Cal Managed Care Plan within 60 days of receiving full-scope Medi-Cal. Children who have a Share of Cost or other health coverage at the time of the transition will still have full-scope Medi-Cal coverage, and remain in fee-for-service.

For more information regarding this expansion, please visit the SB 75 - Full-Scope Medi-Cal for All Children page of the Department of Health Care Services (DHCS) website. For questions regarding this expansion, providers may contact the DHCS Eligibility and Enrollment Division by email at SB75EligibilityandEnrollment@dhcs.ca.gov.