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Retroactive Medi-Cal
Retroactive Medi-Cal may be requested for a child placed in FC three months immediately preceding the month of application. The requestor has 12 months from the month of application to apply for the retroactive Medi-Cal. Eligibility to retroactive Medi-Cal must initiate at intake. Although each specific request should be evaluated separately, general guidelines are to be followed.
Note: For more information regarding the Retroactive Medi-Cal refer to Medi-Cal Handbook Chapter.
Effective Date/Retroactive Medi-Cal
When the FC child/youth is removed from the home they are placed in aid code 45 until an eligibility determination for FC is approved or denied. The effective date for Medi-Cal is the first of the month of application. Three-month retroactive coverage can also be established.
Whenever the FC EW is approving Medi-Cal prior to FC approval, the following requirements apply:
- An “Application and Statement of Facts For Children Not Living with a Parent or Relative For Whom A Public Agency is Assuming Some Financial Responsibility” form (MC 250) must be completed by the FC EW for Medi-Cal aid code 45 before FC benefits are approved. When retroactive Medi-Cal is needed, a “Supplement to the Statement Of Facts for Retroactive Coverage/Restoration” (MC 210A) must be completed by the FC EW for the retro month(s).
- In the rare instance that retroactive Medi-Cal is only requested, an MC 250 must be completed for the first retro month and an MC 210A must be completed for the 2nd and 3rd month(s).
When the information on MEDS is incorrect and CalSAWS has correct information, the FC EW must complete an SCD 1296 and request the MTO complete a manual online transaction to correct the MEDS record.
Retro Medi-Cal Process
When children are placed in FC the FC EW is responsible requesting retroactive Medi-Cal. The FC EW must refer to the following procedures to determine retro Medi-Cal:
- Medi-Cal Handbook Chapter 5.18.
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