By Jason Cinq-Mars, Esq.
The State of California has made some significant changes to the Medi-Cal program in 2022. As of May 1, 2022, eligibility for full-scope Medi-Cal has expanded to include adults who meet Medi-Cal eligibility requirements and are aged 50 or older, regardless of immigration status. This expansion will immediately impact individuals who are on restricted scope benefits, also known as emergency Medi-Cal. These individuals will not need to take any action to receive full-scope Medi-Cal, but will automatically be transitioned to it. If you are not on restricted scope Medi-Cal, then you will need to complete and submit an application to apply. However, while a social security number and/or immigration status may be requested, it is not required to complete the Medi-Cal application.
Additionally, as of July 1, 2022, the State of California has increased the asset limit for non-MAGI Medi-Cal programs. Non-MAGI Medi-Cal programs include the Aged, Blind and Disabled, Medi-Cal with a share of cost, 250% Working Disabled Program, long-term care, and Medicare Savings Programs. Eligibility for these programs require participants to meet an asset or resource limit in order to qualify for benefits. Effective July 1, 2022, the asset limit will be increased from $2,000 for a single person and $3,000 for couples to $130,000 for a single person plus $65,000 for each additional family member. This substantial increase in the asset limit will allow beneficiaries on these programs to save and build their resources without jeopardizing their Medi-Cal enrollment.
Have you heard of PrEP and wondered what it stood for?
PrEP stands for Pre-exposure prophylaxis. PrEP is a daily HIV prevention pill for those who are HIV-negative and want to reduce their risk of exposure to HIV. Research shows that, when taken consistently, PrEP provides protection from contracting HIV in a high percentage of individuals.
The California Department of Public Health Office of AIDS offers assistance to those without insurance to cover PrEP. You may be eligible to receive PrEP free of charge as part of the Patient Assistance Program, known as PrEP-AP. The program provides assistance with PrEP-related medical costs and other medications for the prevention of HIV and the treatment of sexually transmitted infections.
- California resident
- At least 18 years old
- Negative HIV/AIDS test result (dated within six months of the PrEP-AP application)
- Annual Modified Adjusted Gross Income (MAGI) cannot exceed 500% of the Federal Poverty Level
- Medication expenses are not fully covered by Medi-Cal or other third-party payers
- Enrolled in the manufacturer’s assistance program (if eligible)
If an individual is HIV+, the California Department of Public Health Office of AIDS has other programs to help pay for medication and health coverage related expenses: AIDS Drug Assistance Program (ADAP), Health Insurance Premium Payment program (OA-HIPP), Employer-Based Health Insurance Premium Payment (EB-HIPP), and Medicare Part D Premium Payment (MDPP) Assistance.
References and Resources:
Getting to Zero SF PrEP
On September 3, 2019, the California Department of Public Health, Office of AIDS released the AIDS Drug Assistance Program (ADAP) Client portal.
Using the portal, clients enrolled in ADAP can:
- View their client ID, enrollment site, enrollment worker contact information, eligibility status, and eligibility end date
- View the Insurance Assistance Program information if enrolled, including program type (OA-HIPP, EB-HIPP, or MDPP), insurance carrier, eligibility status, and eligibility end date
- Elect to receive automatic notifications about eligibility and re-enrollment
- Recertify if there are no changes to residency or health insurance and annual household income is within program limits
To request access to the Client Portal, contact the ADAP Call Center at 1-844-421-7050, Monday-Friday, 8:00 AM – 5:00 PM. After requesting access, the client will receive an email with a URL to the client portal. Using the link, the client will enter their email address as the username and a temporary password, and then be prompted to create a new password. Contact the ADAP Call Center, with any issues accessing the Client Portal.
For more information about ADAP, go to California Department of Health Office of AIDS webpage.
If you are interested in ADAP and not yet enrolled, contact an ADAP Enrollment Worker to apply. To find an Enrollment Worker in your area, go to ADAP Enrollment Site Locator.
SAN FRANCISCO (June 20, 2019) – PRC, whose nonprofit mission is to provide a variety of legal, social and health services to San Francisco residents affected by HIV/AIDS, substance use or mental health issues, has announced its official endorsement of the Undetectable equals Untransmittable (U=U) campaign
Whether one is affected by HIV or is HIV negative, it is important to know and understand U=U. The U=U campaign was born in New York City and has quickly spread across North America and the global community.
The stigma associated with HIV remains one of the greatest barriers for people in accessing HIV prevention, testing, treatment, and support. PRC’s endorsement of U=U sends a clear message that sharing the knowledge regarding U=U with our San Francisco community is an urgent priority to save lives and fight stigma, as well as is a call to take action to help spread the message.
U=U (Undectable equals Untransmittable) has unequivocally been supported by scientific evidence
. It shows that, when an individual is in HIV Treatment and maintains a suppressed viral load, there is effectively no risk of transmission to their partner during sex.
Through its partnership with Getting to Zero San Francisco, PRC is committed to preventing new HIV diagnoses and supporting people living with HIV to stay in treatment so they can live their best lives.
Continued support of campaigns like U=U is critical to ending HIV-related stigma. This will help us achieve the goals of preventing new diagnoses, reaching undiagnosed individuals, and ensuring that people living with HIV receive the care, treatment and support they need.
PRC (formerly Positive Resource Center) is a San Francisco-based nonprofit that helps people affected by HIV/AIDS, substance use or mental health issues better realize the opportunities available to them. PRC provides integrated legal, social, and health services to address the broad range of social risk factors that impact wellness and limit potential. In 2017, the organization merged with AIDS Emergency Fund (AEF), an emergency financial assistance provider for low-income residents living with HIV/AIDS, and Baker Places, an agency that provides a comprehensive array of residential treatment services to people with mental health, substance use, and HIV/AIDS-related issues. Combined, the three organizations represent a 115-year history of service and serve approximately 5,000 clients annually. For more information, please visit www.prcsf.org
Beginning in June 2019, California residents receiving Supplemental Security Income (SSI) who also receive a State Supplementary Payment (SSP) can get CalFresh benefits
The SSP program was intended to replace the Food Stamp program (now known as CalFresh in California) for SSI beneficiaries when it was implemented in 1974. Over the years, the SSP benefit has remained relatively stable, while CalFresh benefits have increased to reflect inflation. Given the relative loss of value of SSP benefits, the California legislature passed Assembly Bill 1811
to allow SSI/SSP recipients also to receive CalFresh benefits.
This means more opportunities for SSI/SSP beneficiaries to purchase nutritious food
CalFresh is a free nutrition assistance program that enhances the food budgets of low-income individuals. Monthly CalFresh benefits range between $15 to $192 based on household size, income, and monthly expenses. SSI/SSP
recipients can apply for CalFresh benefits to purchase food at vendors who accept EBT such as grocery stores, farmers markets participating in the Market Match
, and restaurants participating in the Restaurant Meals Program
). SSI/SSP beneficiaries who receive CalFresh will have no reduction to their SSI/SSP payment.
Assembly Bill 1811
also resulted in a monthly grant increase of $10 for recipients of the Cash Assistance Program for Immigrants (CAPI) so that SSI/SSP benefits and CAPI benefits are equal. CAPI beneficiaries will remain eligible for CalFresh benefits.
Households already receiving CalFresh who had an excluded SSI beneficiary may receive an increase to their CalFresh benefits. However, this change will increase the overall income for some households as SSI/SSP income will no longer be excluded, which may cause a reduction in the monthly CalFresh grant. For those households who would experience a reduction in CalFresh Benefits, the Supplemental Nutrition Benefit (SNB) and Transitional Nutrition Benefit (TNB) programs will provide additional benefits to avoid any reduction to overall nutrition benefits.
There are three ways to apply
Each applicant may need to provide proof of income, residency, and identity. HSA may be able to help with obtaining these required documents. Learn more about benefits and eligibility
NOTE: Due to the high volume of new applicants, applicants may experience extended wait times at HSA service centers and by phone in June and July 2019. Consider applying online or call (415) 558-4700 to schedule an in-person appointment.