When a Medi-Cal service you want is not approved by a Medi-Cal field office or your managed care plan, you have the right to ask for a state hearing.
Here are some general rules on requesting an hearing:
- In most cases you have ninety (90) days to ask for a hearing.
- The ninety (90) days start the day after the notice is mailed to you to notify you that the services you want will not be provided.
- You have a much shorter time to ask for a hearing if your benefits are being changed or taken away:
- This also applies to you if you belong to a Medi-Cal Managed Care Plan. If your doctor or other medical provider asks for a service your plan will not approve, or your plan will not continue to pay for a service you already have, you have a right to ask for a state hearing.
Want to keep the same benefits while you wait for a hearing?
You must ask for a hearing before the date that your benefits are changed or taken away so that you will receive the same benefits until your hearing.
Do you want help?
If you don't want to attend the hearing alone, you may bring a friend, relative, advocate, or anyone else that you choose. You may get free legal help at your local legal aid office or welfare rights group, which is typically only a google search away.
How to ask for a state hearing
Send your hearing request to:
California Department of Social Services
State Hearings Division
P.O. Box 944243
Mail Station 9-17-37
Sacramento, CA 94244-2430
If you are still confused about this process or would like assistance, please reach out to California Advocacy Group.