Medi-Cal Member Navigation Toolkit

This toolkit provides practical tools and guidance to help community partners support adult Medi-Cal members with navigating eligibility, coverage, and work and community engagement requirements.

  • When to use: Use this tool to give a member a brief introduction to upcoming work and community engagement requirements and six-month eligibility checks, including what may happen if they do not respond and where to get help.

  • When to use: Use this tool when a member or partner asks, “Why did this happen?” or needs a clear, plain-language explanation of a Medi-Cal coverage change. The tool can help reduce confusion and frustration while reinforcing that many coverage issues may be resolved through timely action.

  • When to use: Use this tool when a member, partner, or staff person is unsure whether a Medi-Cal question should go to Department of Social Services (DSS) or CenCal Health. 

  • When to use: Use this tool to give the member clear, easy answers about Medi-Cal coverage, renewal, notices, and common reasons coverage may stop, change, or need follow-up.

  • When to use: Use this tool when a member brings in a Medi-Cal notice or letter and needs help understanding it and identifying next steps.

  • When to use: Use this tool when contact with a hard-to-reach Medi-Cal member creates an important opportunity to review, update, or confirm case information. Because future contact may be difficult, the information gathered may allow the Department of Social Services (DSS) to complete a change-in-circumstance redetermination and establish a new eligibility period. The county—not the assisting organization—makes that determination.

Member Orientation

  • When to use: Use this tool when you need to understand whether a member may be in the Medi-Cal New Adult Group.

  • When to use: Use this tool when a Medi-Cal member receives a notice about a six-month eligibility check or needs help understanding whether they may need to renew Medi-Cal twice a year, what DSS may request, and how to respond.

  • When to use: Use this tool when a member is asked by DSS, via a mailed Medi-Cal Notice Action or an e-Notice through BenefitsCal.com, to verify information for an application, renewal, reported change, or eligibility review. Navigators may help the member understand the request, gather documents, and upload verification, but DSS decides what verification is required and whether it is acceptable.

  • When to use: Use this tool when a member has an upcoming Medi-Cal renewal, six-month eligibility check, verification request, or related deadline and needs help setting reminders before coverage is at risk.

Medi-Cal Eligibility & Renewal

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  • When to use: Use this tool to explain who may need to meet work, job training, school, volunteer, or community service requirements, what activities count, and who may be exempt.

  • When to use: Use this tool when a member may be subject to work and community engagement requirements and may qualify for an exemption. Navigators can help identify possible exemptions, but DSS determines whether the requirements apply, whether an exemption applies, and what verification is required.

  • When to use: Use this tool when a member may qualify for an exemption from the work and community engagement requirements and DSS has requested information or supporting documentation. These requirements apply only to certain adults in the MAGI New Adult Group. Navigators may help members understand requests and gather or upload documents, but DSS determines whether an exemption applies and what verification is required.

Work & Community Engagement

Troubleshooting & Reference Materials

BenefitsCal

  • When to use: Use this tool when a member does not have a BenefitsCal account and needs help creating one.

  • When to use: Use this tool when a member needs help completing or managing two-step verification when signing in to BenefitsCal.

  • When to use: Use this tool when a member has forgotten their BenefitsCal password or needs help resetting it. 

  • When to use: Use this tool when a member has a BenefitsCal account but their existing case does not appear and needs to be linked to the account.

  • When to use: Use this tool when a member needs help finding case information, program status, pending tasks, appointments, notices, documents, or other features on their BenefitsCal dashboard.

BenefitsCal:
Account Access & Setup

  • When to use: Use this tool when a member needs help viewing or sending messages or reviewing and completing an action sent through BenefitsCal.

  • When to use: Use this tool when a member wants to receive electronic notifications and access eligible notices through BenefitsCal instead of relying only on paper notices.

  • When to use: Use this tool when a member needs help locating their assigned caseworker or county contact information available through BenefitsCal.

  • When to use: Use this tool when a member wants to request, review, cancel, or request to reschedule a county appointment through BenefitsCal.

BenefitsCal:
Notices, Communication & Help

  • When to use: Use this tool when a member wants to start, complete, or submit a new benefits application through BenefitsCal.

  • When to use: Use this tool when a member is completing a benefits application and needs help uploading documents as part of the application process.

  • When to use: Use this tool when a member has a renewal due and needs help completing and submitting it through BenefitsCal.

  • When to use: Use this tool when a member has a periodic report due and needs help completing and submitting it through BenefitsCal.

  • When to use: Use this tool when a member needs to report a change to an active benefits case through BenefitsCal or review a change previously reported.

  • When to use: Use this tool when a member needs help uploading documents to an existing case or submitted application.

BenefitsCal: Applications, Renewals & Case Updates

  • When to use: Use this tool when a navigator or CBO needs to determine where to direct a BenefitsCal or CalSAWS question or issue, including when the county should be contacted.

  • When to use: Use this tool when a CBO needs to request organizational access to BenefitsCal or establish the appropriate CBO account.

  • When to use: Use this tool when a CBO Assister or Manager needs help using the BenefitsCal CBO Dashboard and its available organizational functions.

  • When to use: Use this tool when a CBO wants to create or use a BenefitsCal referral link or QR code for outreach and track related activity.

CBO BenefitsCal Tools

  • When to use: Use this tool when a member wants to request an available support service through BenefitsCal, such as a replacement Medi-Cal or EBT card or another support offered for their program and county.

  • When to use: Use this tool when an applicant wants help using the optional Truv feature in BenefitsCal to electronically retrieve and submit available income and employment information during an application.

  • When to use: Use this resource when a member or navigator would benefit from a visual, step-by-step demonstration of how to complete common tasks in BenefitsCal.

Other BenefitsCal Tools

Additional Volunteer Program Resources
Volunteer Program Start-Up Toolkit
Additional Medi-Cal Navigation Resources