Healthcare Assistance for Single Mothers in California: Medi-Cal, CHIP & More [2025]

Last updated: September 2025

This no‑fluff guide shows single moms in California exactly how to get health coverage fast—what to qualify for, the exact income limits for 2025, where to apply, who to call, and what to do if something stalls.

Quick help box

• Apply online right now at BenefitsCal or Covered California. Both use the same application and will sort out if you qualify for Medi-Cal or a subsidized plan. Covered California phone: 800‑300‑1506. (coveredca.com)
• New? You can get temporary coverage while your Medi-Cal is pending. Ask a clinic about Presumptive Eligibility for Pregnant People or Children’s/Hospital Presumptive Eligibility. (dhcs.ca.gov, pan.dhcs.ca.gov)
• Need free plan-picking help or to change plans? Call Medi-Cal Health Care Options at 800‑430‑4263 (TTY 800‑430‑7077). (dhcs.ca.gov)
• Paperwork stuck? Call the Medi-Cal Helpline 800‑541‑5555 or the Medi-Cal Ombudsman 888‑452‑8609. For dental, call 800‑322‑6384. (dhcs.ca.gov, dental.dhcs.ca.gov)
• Find your county office and phone number (to apply, renew, or check status). State directory: “County Offices” page. (dhcs.ca.gov)
• Can’t find a doctor while you wait? Use HRSA’s “Find a Health Center” tool for low‑cost clinics near you. (dhcs.ca.gov)

What’s new and what matters in 2025

• Adults ages 26–49 can qualify for full‑scope Medi‑Cal regardless of immigration status (income rules still apply). Public charge does not consider regular Medi‑Cal benefits. (dhcs.ca.gov)
• Medi‑Cal renewals are back to normal. Update your address, income, and household within 10 days to avoid losing coverage. Renewals come in a large yellow envelope or may auto‑renew. Update details at BenefitsCal. (dhcs.ca.gov)
• Open Enrollment for Covered California runs every year from Nov 1–Jan 31. If you lose Medi‑Cal or other coverage, you get a Special Enrollment window (generally 60–90 days depending on the event). (coveredca.com, www1.coveredca.com)
• Medi‑Cal postpartum coverage lasts a full 12 months after pregnancy ends—no matter how the pregnancy ends, and regardless of changes in income or immigration status. (dhcs.ca.gov)

Quick Reference Cheat Sheet (who qualifies, where to apply)

2025 Income Limits, at a glance (Medi‑Cal, CHIP, MCAP)

Notes:

• Household size for pregnancy programs counts the pregnant individual as one plus the number of expected babies. Example: a pregnant mom expecting one baby with no other children = family size of 2. (dhcs.ca.gov)
• Dollar amounts below come from official 2025 charts or federal poverty guidelines used by California.

Table A — Annual income limits (Adults and Children; 2025)

Source: DHCS adult eligibility chart (138% FPL); DHCS Program Income Eligibility Comparison 2025 (266% FPL for children). (dhcs.ca.gov)

Table B — Pregnancy coverage thresholds (monthly, 2025)

These are the monthly ranges MCAP publishes. The lower number is roughly the 213% FPL pregnancy limit (pregnancy‑related Medi‑Cal); the upper number is 322% FPL (MCAP). Family size counts the pregnant person as 1 plus unborn(s). (dhcs.ca.gov)

Source: DHCS MCAP “Who Qualifies?” (effective Jan 1, 2025). (dhcs.ca.gov)

Table C — MCAP 322% FPL (annual), 2025 (for quick comparison)

Source: DHCS Program Income Eligibility Comparison 2025. (dhcs.ca.gov)

Medi‑Cal (California Medicaid): what single mothers need to do first

Most important action: apply now—don’t wait for the perfect stack of papers. Start online at BenefitsCal or Covered California; your county may ask for extra proof later. Medi‑Cal decisions normally take up to 45 days (90 if disability‑based). If you need care now, ask about temporary eligibility options listed below. (dhcs.ca.gov)

What Medi‑Cal covers:

• Primary care, hospital, pharmacy, pregnancy care, mental health and substance use treatment, dental (Medi‑Cal Dental), transportation to appointments, vision services, and more (extra pediatric services under EPSDT for kids under 21). (dhcs.ca.gov)

Key 2025 eligibility rules:

• Adults 19–64: up to 138% FPL by household size (see Table A). (dhcs.ca.gov)
• Children: up to 266% FPL with no monthly premiums for “Medi‑Cal for Families” (premiums reduced to $0 since July 1, 2022). (dhcs.ca.gov, pan.dhcs.ca.gov)
• Immigration: As of Jan 1, 2024, adults 26–49 qualify for full‑scope Medi‑Cal regardless of immigration status; using Medi‑Cal does not count against you for public charge (except long‑term institutional care). (dhcs.ca.gov)

How to apply

• Online: BenefitsCal or Covered California (same application routes to Medi‑Cal or a discounted plan). Phone help at 800‑300‑1506. (coveredca.com)
• In person/phone: Call your county Medi‑Cal office (examples in “Resources by Region” below; full state list on DHCS “County Offices”). (dhcs.ca.gov)
• Need a plan? After your Benefits Identification Card (BIC) arrives, you’ll choose a managed care plan (or one is assigned) and a primary care provider. For plan help or to change plans, call Health Care Options 800‑430‑4263. (dhcs.ca.gov)

Required documents (don’t delay if something is missing):

• ID; SSN if you have one; proof of income (paystub, 1040, or employer letter); proof of deductions like child care; immigration document if you have one; you can self‑attest income if paid in cash. (dhcs.ca.gov)

Timeline reality check

• Standard processing is up to 45 days (up to 90 days if disability is involved). If nothing arrives by then, you can request a state fair hearing. Coverage, once approved, goes back to the first day of your application month, and Medi‑Cal can also pay bills up to the prior 3 months if you were eligible (ask for retroactive Medi‑Cal). (dhcs.ca.gov)

What to do if this doesn’t work (Plan B)

• Visit an HRSA‑funded community health center for low‑cost care while you appeal or reapply—search by zip code. (dhcs.ca.gov)
• If you lose Medi‑Cal due to income, Covered California gives you a Special Enrollment window (generally 60–90 days) to move into a subsidized plan. (coveredca.com)

Pregnancy and Postpartum Coverage (Medi‑Cal & MCAP)

Most important action: if you’re pregnant, ask a clinic to enroll you in Presumptive Eligibility today so you can start prenatal care immediately while your full application is processed. It covers prenatal visits, some prescriptions, and abortion care pending full approval. (dhcs.ca.gov)

How coverage works in California:

• Up to 138% FPL: full‑scope Medi‑Cal during pregnancy and through 12 months postpartum. (dhcs.ca.gov)
• 138%–213% FPL: pregnancy‑related Medi‑Cal (broad set of medically necessary pregnancy services) with the same 12‑month postpartum extension. (dhcs.ca.gov)
• Above 213%–322% FPL: Medi‑Cal Access Program (MCAP), with no copays or deductibles; baby is then eligible for the Medi‑Cal Access Infant Program (MCAIP) for up to 2 years. (dhcs.ca.gov)

Fast‑track options (use these if you can’t wait):

• Presumptive Eligibility for Pregnant People (PE4PW): immediate, temporary prenatal coverage via certain clinics and providers. Search “Qualified Providers by County” or ask your OB/GYN or community clinic. (dhcs.ca.gov, pan.dhcs.ca.gov)
• Hospital Presumptive Eligibility: if you’re seen at a hospital, ask about HPE to get up to two months of no‑cost temporary Medi‑Cal. (pan.dhcs.ca.gov)

Income examples for 2025 (family size includes unborn)

• Family of 2 (pregnant with no other children): pregnancy‑related Medi‑Cal up to about $3,756/month\ast \ast ;MCAPupto\ast \ast$5,677/month. (dhcs.ca.gov)
• Family of 4: pregnancy‑related Medi‑Cal up to $5,709/month\ast \ast ;MCAPupto\ast \ast$8,630/month. (dhcs.ca.gov)

Postpartum:

• Everyone on pregnancy Medi‑Cal or MCAP gets 12 months of full postpartum coverage regardless of income changes or how the pregnancy ends. (dhcs.ca.gov)

Doulas, lactation, and more:

• Medi‑Cal covers doula services statewide (initial visit, up to eight prenatal/postpartum visits, support during labor/abortion/miscarriage, and two extended postpartum visits; more visits available with a provider’s recommendation). Ask your plan or check the DHCS doula directory. (dhcs.ca.gov)

Real‑world example

• Example: A Fresno mom with one child becomes pregnant. Household size is 3 (she counts as 2 while pregnant, plus one child). With income of $4,600/month\ast \ast ,shequalifiesforpregnancy‑relatedMedi‑Cal(213$4,731/month). She applies online, gets a PE card from her clinic the same day, and her BIC arrives 4 weeks later. (dhcs.ca.gov)

What to do if this doesn’t work (Plan B)

• If your income is just above Medi‑Cal pregnancy limits, apply for MCAP through Covered California or call 800‑300‑1506 to switch from a Covered CA plan to MCAP. (dhcs.ca.gov)

Covered California (if you don’t qualify for Medi‑Cal)

Most important action: if your income is too high for Medi‑Cal, apply at CoveredCA.com or call 800‑300‑1506. Financial help (APTC) lowers monthly premiums; cost‑sharing reductions can cut copays and deductibles if your income is modest. Open Enrollment: Nov 1–Jan 31. If you lose Medi‑Cal, you get a Special Enrollment Period. (coveredca.com)

Tips for single moms choosing a plan:

• Check your children’s doctors and your OB/GYN in-network first.
• Silver plans often bring extra cost‑sharing help if you qualify.
• If you’re American Indian/Alaska Native (federally recognized), you can enroll any time and change plans monthly. (coveredca.com)

What to do if this doesn’t work (Plan B)

• If premiums are still too high, re‑check Medi‑Cal eligibility after any income change or when your household size changes (new baby, custody changes). Report changes within 10 days. (dhcs.ca.gov)

Dental and Vision benefits under Medi‑Cal

Most important action: if you have Medi‑Cal, you also have dental and vision benefits—use them.

Medi‑Cal Dental (Denti‑Cal)

• Covered services include exams, X‑rays, cleanings, fillings, extractions, root canals, crowns, periodontal care, dentures, and orthodontics for children who qualify. Find a dentist or call the member line 800‑322‑6384. (dhcs.ca.gov, dental.dhcs.ca.gov)

Vision (full‑scope Medi‑Cal)

• Routine eye exam every 24 months for all members. Eyeglasses (frames and lenses) are covered benefits; managed care plans often partner with VSP or other networks. Details and provider directory on DHCS vision pages. (dhcs.ca.gov)

What to do if this doesn’t work (Plan B)

• If you can’t find a dentist or optometry appointment, call your plan’s member services or the Medi‑Cal Dental line for help locating a provider. (dental.dhcs.ca.gov)

Transportation to appointments (NMT & NEMT)

Most important action: call your managed care plan’s member services a few days ahead to set up rides.

• Non‑Medical Transportation (NMT): rides by private/public vehicle when you have no other way to get to a Medi‑Cal‑covered appointment. No prescription is required; you attest you have an unmet transportation need. (dhcs.ca.gov)
• Non‑Emergency Medical Transportation (NEMT): for those who cannot use a car or bus due to medical reasons (wheelchair van, gurney/litter van, ambulance). Requires a provider prescription. (dhcs.ca.gov)
• Request rides at least five business days ahead when you can; sooner for ongoing treatments. (dhcs.ca.gov)

What to do if this doesn’t work (Plan B)

• Fee‑for‑service members can email DHCSNMT@dhcs.ca.gov to coordinate rides securely; if urgent, call your plan and ask for transportation escalation. (dhcs.ca.gov)

Behavioral health (mental health and substance use)

Most important action: call your plan or county access line if you need care; in a crisis, call 988.

• Mild‑to‑moderate mental health care through your Medi‑Cal plan; specialty mental health through county mental health plans. DHCS is integrating systems to simplify access. (dhcs.ca.gov)
• Every county has a 24/7 mental health access or crisis line. CA.gov central page points to county hotlines. (ca.gov)

What to do if this doesn’t work (Plan B)

• Call the Health Consumer Alliance 888‑804‑3536 for free legal help with denials or barriers. (dhcs.ca.gov)

Extra programs single moms should know

• California Children’s Services (CCS): for kids up to 21 with certain serious medical conditions. Financial criteria: families with AGI ≤ $40,000, or higher if out‑of‑pocket costs exceed 20% of AGI. Children on Medi‑Cal may also qualify. Contact your county CCS office. (dhcs.ca.gov)
• Hearing Aid Coverage for Children Program (HACCP): for kids 0–20 not on Medi‑Cal/CCS and lacking hearing aid coverage. Income up to 600% FPL (e.g., family of 4 up to $192,900/year in 2025). (dhcs.ca.gov)
• Children’s preventive care (EPSDT): kids under 21 get extra medically necessary services beyond standard adult benefits. (dhcs.ca.gov)

Pick or change your Medi‑Cal plan

Most important action: use the DHCS Health Plan Directory to see the plans in your county, then enroll or switch if needed.

• Health Plan Directory and enroll/switch help: Medi‑Cal Health Care Options 800‑430‑4263 (TTY 800‑430‑7077). (dhcs.ca.gov)

Continuity of Care tip:

• If a doctor you’ve seen isn’t in your new plan, you may be able to keep them for up to 12 months. Ask your plan about Continuity of Care protections. (pan.dhcs.ca.gov)

What to do if this doesn’t work (Plan B)

• Call the Medi‑Cal Ombudsman 888‑452‑8609 for plan problems. (dhcs.ca.gov)

Application Checklist (bring what you can; don’t wait)

• Photo ID (if available); SSN if you have one
• Proof of income (recent pay stub, 1040, employer letter; self‑attest if paid cash)
• Proof of deductions (childcare, child support, alimony, health insurance)
• Address and household info (who lives with you; pregnancy status)
• Immigration document if you have one (not required for emergency/pregnancy‑only) (dhcs.ca.gov)

Common mistakes to avoid

• Missing your renewal mail. If you move, update your address within 10 days. (dhcs.ca.gov)
• Not asking for temporary coverage. Pregnant? Ask clinics about Presumptive Eligibility. Hospital visits? Ask about Hospital Presumptive Eligibility. (dhcs.ca.gov, pan.dhcs.ca.gov)
• Waiting to apply until you have every document. Apply first; the county will request anything else.
• Not requesting retroactive Medi‑Cal for recent medical bills (up to the 3 months prior to your application). (dhcs.ca.gov)
• Not using plan member services. They can help you find OB/GYNs, pediatric dentists, therapists, and arrange rides.

Realistic timelines

• Standard application: up to 45 days (90 days if disability‑based). Backlogs happen—politely (but persistently) follow up with your county office by phone. (dhcs.ca.gov)
• Coverage start: once approved, Medi‑Cal is effective the first day of your application month; ask about retroactive coverage for bills in the 3 months before you applied. (dhcs.ca.gov)
• Covered California: apply during Open Enrollment (Nov 1–Jan 31) or within 60–90 days of losing Medi‑Cal. (coveredca.com)

Language and accessibility help

• Free interpreters are your right. Plans must provide qualified interpreters and translated materials at no cost. (dmhc.ca.gov)
• DHCS language access help lines (including dental, managed care, mental health) are listed on the DHCS Language Access page. (dhcs.ca.gov)

Resources by Region (quick county contacts)

• Los Angeles County DPSS: 866‑613‑3777 (apply/renew Medi‑Cal); My Health LA ended Jan 31, 2024 due to statewide Medi‑Cal expansion. (dhcs.ca.gov, dhs.lacounty.gov)
• San Diego County HHSA: 866‑262‑9881. (dhcs.ca.gov)
• San Francisco HSA: 855‑355‑5757; Healthy San Francisco (for SF residents who don’t qualify elsewhere) 415‑615‑4555. (dhcs.ca.gov, healthysanfrancisco.org)
• Alameda County SSA: 888‑999‑4772. (dhcs.ca.gov)
• Fresno County DSS: 855‑832‑8082. (dhcs.ca.gov)
• Santa Clara County SSA: 408‑758‑3800. (dhcs.ca.gov)
• Orange County SSA: 800‑281‑9799. (dhcs.ca.gov)
• Riverside County DPSS: 877‑410‑8827. (dhcs.ca.gov)
• Kern County DHS: 661‑631‑6807. (dhcs.ca.gov)
• Butte County DESS: 877‑410‑8803. (dhcs.ca.gov)

Full list (all 58 counties): see DHCS “County Offices.” (dhcs.ca.gov)

“More than medical”: helpful add‑ons for families

• Transportation to medical, dental, mental health appointments (NMT/NEMT) through your plan. (dhcs.ca.gov)
• Medi‑Cal Dental member line 800‑322‑6384 for provider help and benefits. (dental.dhcs.ca.gov)
• Vision: routine exams and glasses benefits—ask your plan or DHCS Vision. (dhcs.ca.gov)
• HRSA “Find a Health Center” for low‑cost clinics while you wait. (dhcs.ca.gov)

Diverse communities: tailored help

• LGBTQ+ single mothers: your plan must provide respectful, language‑appropriate care and covered services (including perinatal, behavioral health). Use plan member services for provider matching and language access; escalate access problems to the DMHC Help Center if needed. (dmhc.ca.gov)
• Single mothers with disabilities or caring for a child with disabilities: ask your plan about Enhanced Care Management (ECM). Kids with certain serious conditions may qualify for California Children’s Services (CCS). (dhcs.ca.gov)
• Veteran single mothers: Medi‑Cal can coordinate with VA benefits; report all coverage in your application so bills route correctly.
• Immigrant and refugee single moms: full‑scope Medi‑Cal is available based on income regardless of immigration status for many age groups; using Medi‑Cal does not count for public charge (except long‑term institutional care). For application help, your county office and community clinics can assist in your language. (dhcs.ca.gov)
• Tribal citizens: members of federally recognized tribes can enroll in Covered California any time and change plans monthly; Medi‑Cal eligibility follows standard income rules. (coveredca.com)
• Rural moms with limited access: ask your plan for transportation (NMT/NEMT) and telehealth options; HRSA centers often provide same‑week appointments. (dhcs.ca.gov)
• Single fathers and other caregivers: these rules apply to you, too—Medi‑Cal and children’s programs are based on household and tax rules, not marital status.
• Language access: you have a right to a qualified medical interpreter at no cost. Ask your plan or provider; if you have issues, see DMHC’s Language Assistance page. (dmhc.ca.gov)

Managed care plan basics and member rights

• View plans in your county and enroll/switch with help from Health Care Options (800‑430‑4263). If a provider you see is not in your new plan, ask for Continuity of Care (up to 12 months if criteria met). (dhcs.ca.gov, pan.dhcs.ca.gov)
• Dental: if you live in LA or Sacramento counties, dental may be through a managed care dental plan; otherwise it’s fee‑for‑service—call 800‑322‑6384 for details. (pan.dhcs.ca.gov)
• Vision: most plans contract with VSP or similar partners for network eye care. (dhcs.ca.gov)

Extra tables you can use quickly

Table D — What to do while your application is pending

Table E — Transportation types

Table F — Dental and Vision Quick List

10 California‑specific FAQs

1. How long will my Medi‑Cal application take?
   Up to 45 days (or 90 days if disability‑based). If you don’t get a decision by then, you can request a state fair hearing. (dhcs.ca.gov)
2. I’m pregnant now. Can I see a doctor this week?
   Yes—ask a clinic for Presumptive Eligibility for Pregnant People (PE4PW). It gives immediate temporary coverage for prenatal care while your full application is processed. (dhcs.ca.gov)
3. My child needs care and we’re still waiting. Any faster option?
   Ask the clinic about Children’s/CPE or Accelerated Enrollment. Kids can get full‑scope temporary coverage while the application finishes. (dhcs.ca.gov)
4. Do Medi‑Cal kids still pay monthly premiums?
   No. Children’s Medi‑Cal premiums were reduced to $0 on July 1, 2022. (pan.dhcs.ca.gov)
5. Are doulas covered?
   Yes. Medi‑Cal covers doula services (visits before/after birth and support during labor). Ask your plan for help connecting to a doula. (dhcs.ca.gov)
6. Does Medi‑Cal count against me for public charge?
   No. Regular Medi‑Cal benefits (not long‑term institutional care) are not considered for public charge. (dhcs.ca.gov)
7. I lost Medi‑Cal because my income went up. Now what?
   Enroll through Covered California within the Special Enrollment window (generally 60–90 days after losing Medi‑Cal). Financial help can reduce your monthly premium. (coveredca.com)
8. Can Medi‑Cal pay bills from before I applied?
   Possibly. Ask your county for retroactive Medi‑Cal for up to the 3 months before your application if you were eligible in those months. (dhcs.ca.gov)
9. How do I pick or change my Medi‑Cal plan?
   Use the DHCS Health Plan Directory for your county and call Health Care Options at 800‑430‑4263. (dhcs.ca.gov)
10. What if I need an interpreter?
    Your plan must provide qualified interpreters free of charge. If you run into problems, DMHC’s Language Assistance page explains your rights. (dmhc.ca.gov)

How to fix common snags (step‑by‑step)

• No response and you’re near day 45? Call your county office (see “County Offices” page) with your case number. Ask if any verifications are missing and submit them the same day via BenefitsCal or at the lobby scanner. (dhcs.ca.gov)
• Doctor not taking your plan? Call your plan’s member services and ask for help finding a provider. If you recently switched plans and need to keep your current doctor temporarily, ask for “Continuity of Care.” (pan.dhcs.ca.gov)
• Need rides? Request NMT/NEMT from your plan a few days ahead. For fee‑for‑service members, email DHCSNMT@dhcs.ca.gov to start a secure request. (dhcs.ca.gov)
• Stuck on dental? Call 800‑322‑6384 to locate a Denti‑Cal provider or ask your plan if you’re in a dental managed care county. (pan.dhcs.ca.gov)

About the numbers in this guide (and why they’re trustworthy)

• Adult Medi‑Cal (138% FPL) 2025 limits are posted by DHCS. Children’s 266% FPL and MCAP 322% FPL annual amounts come from DHCS’s 2025 Program Income Eligibility Comparison chart. Pregnancy monthly thresholds (213%/322%) come from MCAP’s official January 1, 2025 guidelines. Federal 2025 poverty levels are posted by HHS/ASPE. (dhcs.ca.gov, aspe.hhs.gov)

About This Guide

Compiled by the ASingleMother.org Editorial Team

This guide uses official sources from California Department of Health Care Services (DHCS), Covered California, HHS/ASPE, and established nonprofits. It follows our Editorial Standards, which include primary‑source verification, link testing, screenshot documentation for key policy pages, and 48‑hour updates for verified corrections. See our full Editorial Policy. (dhcs.ca.gov)

Last verified September 2025; next review April 2026.

Found an error or an outdated link? Email info@asinglemother.org and we’ll review within 48 hours.

Disclaimer

This guide is for general information. Program rules, income limits, plan networks, and policies change. Always verify details with your county Medi‑Cal office, DHCS, or Covered California before acting. We link only to official and trusted sources and keep our site secure; however, you use external sites at your own risk.

Security note: We never ask for your SSN or full case number by email. Use official portals (BenefitsCal or CoveredCA.com) or call your county office for sensitive information. (dhcs.ca.gov, coveredca.com)

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Helpful official links in one place

• Apply or renew (Medi‑Cal/Covered CA shared application): Covered California — Apply (phone 800‑300‑1506) and your county via DHCS County Offices. (coveredca.com, dhcs.ca.gov)
• Income charts (2025): DHCS Adult 138% FPL Chart and DHCS 2025 Program Income Eligibility Comparison (PDF). (dhcs.ca.gov)
• Pregnancy & MCAP: MCAP — Who Qualifies & Income; Presumptive Eligibility for Pregnant People. (dhcs.ca.gov)
• Plan help: Medi‑Cal Health Care Options & Plan Directory (phone 800‑430‑4263). (dhcs.ca.gov)
• Dental & Vision: Medi‑Cal Dental — Member Info (phone 800‑322‑6384); Medi‑Cal Vision Benefits. (dental.dhcs.ca.gov, dhcs.ca.gov)
• Transportation: DHCS Transportation (NMT/NEMT). (dhcs.ca.gov)
• Federal poverty guidelines (2025): HHS/ASPE Poverty Guidelines. (aspe.hhs.gov)

If you need one‑on‑one help today, call your county office (see DHCS County Offices), or Covered California at 800‑300‑1506 for enrollment help. (dhcs.ca.gov, coveredca.com)

— End of guide —

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