California Department of Social Services - State Hearings
Division
Notes from the Training Bureau - September 29, 1996
| Item 96-09-02E California Medical Assistance (Medi-Cal) -- Retroactive Benefits |
Two Medi-Cal regulations address retroactive Medi-Cal benefits: California Code of Regulations (CCR) §§50148 and 50710. Do not confuse these two regulations.
CCR §50710 provides that when a person applies for Medi-Cal, he/she may also apply for Medi-Cal for the three months prior to the month of application.
Example: An individual (or family) may submit a Medi-Cal application in October 1996 and may also apply, at the same time, for retroactive Medi-Cal for July, August, and/or September 1996, as these three months immediately precede October 1996, the month of application.
CCR §50148(b) provides that if an individual (or family) has already applied for Medi-Cal, he/she may apply for retroactive coverage if the request is submitted within one year of the month for which retroactive coverage is requested.
Example: An individual (or family) who applied for Medi-Cal in October 1996 without requesting retroactive Medi-Cal for July, August, or September (the three months immediately preceding the October application), may subsequently apply for retroactive Medi-Cal for these three months (July, August, and/or September 1996), if the subsequent application is filed within one year of each month for which retroactive Medi-Cal is sought. This means a subsequent application filed in July 1997 seeking retroactive Medi-Cal for the three months immediately preceding an October 1996 application is timely because July 1997 is within one year of July, August, and/or September 1996. However, a subsequent application filed in December 1997 seeking retroactive Medi-Cal for the three months immediately preceding an October 1996 application, is not timely because July 1997 is more than one year after July, August, and/or September 1996.