With the enactment of the Affordable Care Act in 2010 and the expansion of Medicaid, nearly 93% of Californians currently have health care coverage.
But according to estimates from the UC Berkeley Center on Labor Research and Education and the UCLA Center for Health Policy Research, there are still nearly 900,000 people who are uninsured just in Los Angeles County. Of those, 48,000 are eligible to be covered under Medi-Cal, a government insurance program for low-income people, but have not enrolled.
Boyle Heights is home to many low-income families, many of whom lack health insurance. Many don’t understand the health care system and the options that might be available to them, and some use the emergency rooms in local hospitals for primary care.
Medi-Cal provides primary, specialty, mental health and dental care, as well as hospitalization. Undocumented immigrant children can be covered until age 18, and, after next January 1, through age 25. In general, to be eligible for Medi-Cal coverage, foreign-born adults must be legal residents or U.S. citizens, although Medi-Cal covers emergency care and pregnancy for undocumented immigrants. (See the chart below for income requirements.)
At the Wellness Center in Boyle Heights, navigators help residents find appropriate coverage and services. Located in the old county General Hospital, the Center sees an average of 500 people a month, many of them patients sent over from the adjacent hospital because they are not insured.
“A large percentage don’t know or are unaware there are these social programs like Medi-Cal or Covered California,” says Haidy Juárez, a navigator. She says navigators can help clients determine whether or not they qualify for Medi-Cal by conducting short interviews.
The Medi-Cal application process usually takes 45 days, longer if clients lack the necessary paperwork. While Wellness Center navigators do not specialize in Medi-Cal, they are able to direct clients to other service providers who do. Maternal and Child Health Access (MCHA) is one of the many organizations that can help residents through the sign up process.
MCHA is a nonprofit organization that helps low-income families receive health care coverage. MCHA also offers support to their clients after the application process is over. “We do a lot of intensive follow-up and case management,” says Celia Valdez, program director at MCHA. “We make sure that they get their coverage, use their services and they stay on for the year.”
MCHA also troubleshoots clients’ problems with Medi-Cal, whether they are not receiving the proper services or are having problems receiving services.
To apply for Medi-Cal, applicants need to prove residency; income; identity (Social Security card, California ID, green card and/or driver’s license); and U.S. citizenship or legal immigration status (for adults 18 and over). After acceptance for Medi-Cal, eligibility must be reviewed annually.
Residents who do not have proof of legal immigration status have to fill out a separate form asking when they came into the country, among other questions.
For immigrants who are undocumented, other programs in Los Angeles provide health care coverage. My Health LA is a program offered by L.A. County to provide nearly 700,000 undocumented immigrants with health care coverage. Clients receive free health services, such as primary care, specialty care and dental care, at local community health clinics.
Income Eligibility for Medi-Cal
|Family Size||Maximum Annual Income (138% Poverty Level)|
|Each additional person||Add 5,741|
Source: California Department of Health Care Services
1111 W. 6th St., #400
MCHA helps low-income women and families enroll in low-cost health coverage programs. MCHA also helps people who have problems with Medi-Cal coverage. At the Wellness Center, MCHA offers various health education workshops.
Edward R. Roybal Comprehensive Health Center
245 S. Fetterly Ave.
The Edward R. Roybal Comprehensive Health Center provides primary, outpatient and specialty care services to patients who have a Medi-Cal health plan through LA Care or Health Net. Uninsured patients with an urgent health problem can be seen only in the urgent care department. Hours: 8 a.m.-5 p.m., Monday-Friday; 8:30 a.m.-5 p.m., Saturday-Sunday.
2051 Marengo St
The LAC+USC Medical Center is the county hospital. The center has various clinics specializing in medical, surgical, emergency/trauma, obstetrical, gynecological, pediatric and psychiatric. The center also houses the Rand Schrader HIV/AIDS Clinic.
Los Angeles County Department of Social Services
Lincoln Heights Sub Office – 66
4077 N. Mission Rd.
The Lincoln Heights office offers Medi-Cal assistance Monday through Friday from 8 a.m,to 5 p.m., as well as help enrolling in CalWORKS and CalFRESH.
Los Angeles County Department of Social Services
Belvedere – 05
5445 Whittier Blvd.
Belvedere 05 office offers Medi-Cal help Monday through Friday from 8 a.m.-5 p.m., as well as help enrolling in CalWORKS and CalFRESH