Medi-Cal Core Academy

Course Overview

Medi-Cal Core Academy is a six-day training series designed to equip participants with the knowledge and skills to effectively manage a Medi-Cal caseload from intake through renewal. Through interactive sessions, participants will explore the history and evolution of Medi-Cal, gain a clear understanding of eligibility requirements across programs, and develop practical system navigation skills within CalSAWS, CalHEERS and MEDS.

The Academy also highlights current program requirements, including asset verification, recent system updates, specialized program segments and changes to non-citizen eligibility. Participants will leave with best practices to ensure timely and accurate case management.

Modules

Module 1: Understanding Medi-Cal Eligibility and Structure

This module provides a foundational overview of the Medi-Cal program, exploring its historical development, organizational hierarchy and eligibility frameworks. Participants will gain insight into household composition distinctions under MAGI and Non-MAGI rules, understand tax household dynamics and linkage, and learn the role of authorized representatives.

Topics include:
• Program overview and history
• Medi-Cal hierarchy
• Household composition (MAGI and Non-MAGI)
• Tax household and linkage
• Authorized representative

Module 2: Medi-Cal Eligibility Fiscal Essentials

This module introduces key Medi-Cal eligibility fiscal components, including income determination, budget periods and methodologies, property evaluation and navigation of MEDS. Participants will gain practical knowledge to assess eligibility accurately within California’s public health coverage program.

Topics include:
• Income budget periods and methodologies
• Property
• MEDS

Module 3: CalHEERS Fundamentals for Eligibility

This module equips eligibility workers with essential skills to navigate and utilize CalHEERS, California’s healthcare eligibility, enrollment and retention system. Participants will also learn about the interactions between CalHEERS and CalSAWS.

Topics include:
• Overview of CalHEERS and its role in health programs
• Eligibility, enrollment and retention functions
• Walkthrough of the CalHEERS interface and key features
• Eligibility determination with CalSAWS and CalHEERS
• Common issues and troubleshooting

Module 4: Understanding the Medi-Cal Eligibility and Renewal Process

This module provides an overview of application and renewal procedures. Participants will learn how to interpret MAGI referrals, verify identity and citizenship, and guide customers through coverage options. The training also covers managing changes in circumstance, the ex parte review process and the 90-day cure period.

Topics include:
• Application process and MAGI referrals
• Identity verification and proofing
• Customer coverage options
• Citizenship requirements
• Renewal process
• Changes in circumstance
• Ex parte review
• 90-day cure period
• Verification requests

Module 5: Medi-Cal County Transfers, Special Programs and Eligibility Pathways

This module explores processes and programs that affect eligibility, coverage and continuity of care. Participants will examine residency changes, county transfers and unique pathways that impact beneficiaries.

Topics include:
• Inter-county transfer (ICT) process
• Residency and county of responsibility
• Managed care
• Special programs
• Medicare Savings Program
• Spousal impoverishment and long-term care
• Transitional Medi-Cal
• Pickle, DAC, DW
• Working Disabled Program
• Craig v. Bonta

Module 6: Medi-Cal Administrative Excellence

This module introduces strategies and tools to improve workflows, increase productivity and ensure compliance. Participants will learn practical approaches to managing caseloads and using system tools effectively.

Topics include:
• Best practices for efficiency and compliance
• Workstation organization
• Caseload management
• CalSAWS reports
• Task management
• MEDS alerts