On April 29, the Department of Health Care Services (DHCS) released a Medi-Cal Eligibility Division Information Letter (MEDIL) to provide guidance to counties on the Medi-Cal eligibility of Ukrainian nationals arriving in California. Ukrainians will enter the U.S. with a variety of immigration statuses. The MEDIL provides guidance on how to establish Medi-Cal eligibility for this population based on current Medi-Cal policy for state and federal Medi-Cal benefits. DHCS will continue to work closely with the state Office of Refugee Health and stakeholders to ensure that new Ukrainian arrivals receive the Medi-Cal benefits to which they are entitled.
Ukrainian refugees can qualify for full-scope Medi-Cal under Permanently Residing Under Color of Law (PRUCOL) status, and hospitals may also use Hospital Presumptive Eligibility (HPE) to provide time-limited full-scope Medi-Cal eligibility. Under HPE, refugees can self-attest that their current residence is in California even if it is only temporary, and applicants are not required to provide proof of income, immigration status, or state of residency.
For unaccompanied minors, hospitals can apply on the minor’s behalf at the hospital, or the social worker of the minor can also do so. If these minors are part of the Unaccompanied Refugee Minor (URM) program, administered by federal Office of Refugee Resettlement, they are treated as foster children and must follow the URM process, which is outlined in All County Welfare Director Letter 18-14.
It is important to remember that Medi-Cal provides full-scope, state-only coverage to all eligible individuals who are25 and under or 50 and over, regardless of immigration status. Therefore, there are multiple pathways for refugees to receive coverage under Medi-Cal, whether they are initially seeking care at a hospital by using HPE or for ongoing full-scope coverage using PRUCOL eligibility pathways or state-only coverage (depending on their age).