State Hearing Requests
If you disagree with an action taken by the County or the Department of Health Care Services, or you disagree with an eligibility determination made by Covered California, you have 90 days to request a state hearing. After 90 days, you must prove you had a good reason for asking late.
If you disagree with an action taken by your Medi-Cal managed care plan, you generally must first file an appeal with your managed care plan. You have 60 calendar days from the date of the notice of action to file an appeal with the managed care plan. If the appeal with the managed care plan does not resolve the issue, you have 120 calendar days from the date of the plan’s Notice of Appeal Resolution to request a state hearing. You may also request a state hearing if you filed an appeal with the managed care plan and you have not received a Notice of Appeal Resolution within 30 days.
**Redetermination of Medi-Cal eligibility was paused during the Public Health Emergency. Counties began processing Medi-Cal redeterminations again in June of 2023.
With the resumption of redeterminations, DHCS received approval from CMS to temporarily extend the timeframe permitted for Medi-Cal members to request a redetermination eligibility-related fair hearing to 120 days from the date the notice of action is mailed. The temporary extension for Medi-Cal members to request a fair hearing is effective from April 1, 2023, through September 30, 2024. This extended time frame only includes redetermination eligibility-related fair hearing requests, including terminations of Medi-Cal eligibility, reductions in benefits (from full Medi-Cal benefits to limited Medi-Cal benefits), and increases in beneficiary liability or share-of-cost. The extended time frame does not apply to new Medi-Cal applications, medical exemption requests or hearing requests related to a request for a particular treatment or service under the Medi-Cal program.
Why Request a Hearing: If you have applied for, have received, or are currently receiving benefits/services from an assistance program listed below and you receive a Notice of Action from a County or a letter from Covered California denying or reducing your benefits, or you turned in an application or other information and the county or Covered California did not act on it, you can ask for a State Hearing.
The Assistance Programs are:
- Adoption Assistance Program
- Adult Services
- Assistance Doc Special Allowance Program
- California Food Assistance Program (CFAP)
- California Work Opportunity and Responsibility to Kids (CalWORKs)
- Cash Assistance Program for Immigrants (CAPI)
- Child Welfare Services
- County Medical Services Program (if your complaint is about scope of benefits)
- Covered California
- Emergency Assistance
- Foster Care
- In-Home Medical Care
- In-Home Supportive Services (IHSS)
- Interim Assistance for SSI applicants
- Modified Adjusted Gross Income (MAGI Medi-Cal)
- Multipurpose Senior Services Program (MSSP)
- Personal Care Services Program (PCSP)
- Refugee Cash Assistance
- Repatriate Assistance Program
- Resource Family Approval (RFA)
- Special Circumstance Payment (State Supplemental Program)
- Trafficking and Crime Victims Assistance Program
How to Request a Hearing On-Line: Request a Hearing Online
How to Request a Hearing or an Expedited Hearing by Phone:
Call the State Hearings Division toll free (800) 743-8525
How to Request a Hearing in Writing: You may complete the "Request for State Hearing" on the back of the Notice of Action or put your request on a separate piece of paper. Please provide all requested information such as your full name, address, telephone number, the name of the county that took the action against you, the aid program(s) involved, and a detailed reason why you want a hearing. If you have trouble understanding English, be sure to tell us your language (and dialect) so we can arrange for you to have language assistance at the hearing. If you have chosen an authorized representative, be sure to tell us his/her name and address. If you wish, you may attach a letter in which you explain why you believe the county action is not correct. It is always a good idea to keep a copy of your hearing request.
Submit your request to the county welfare department at the address shown on the Notice of action, by mail to:
California Department of Social Services
State Hearings Division
P.O. Box 944243, Mail Station 9-17-442
Sacramento, California 94244-2430