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Medi-Cal Enrollment by Eligibility Group
This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).
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Newly Eligible Individuals enrolled in Medi-Cal Managed Care Health Plans
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This dataset includes the number of newly eligible individuals enrolled in a Medi-Cal Managed Care Health Plans by type of enrollment by reporting period. Medi-Cal Managed Care program contracts for health care services through established networks of organized systems of care emphasizing primary and preventive care. Newly eligible Medi-Cal beneficiaries must choose a Managed Care health plan within 30 days of Medi-Cal enrollment, or they will be enrolled in a Managed Care health plan by default. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.
Eligible Individuals Enrolled in Medi-Cal Managed Care COHS Health Plans
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This dataset includes the number of newly eligible individuals enrolled in a Medi-Cal Managed Care County Organized Health System (COHS) Health Plans by reporting period. COHS is a Medi-Cal managed care health plan model that operates in 22 California counties. Each COHS is created by a county board of supervisors and governed by an independent commission. In COHS counties, a single plan serves all Medi-Cal beneficiaries enrolled in managed care. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.
Medi-Cal Managed Care Enrollment Report
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This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.
Enrollment Data
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Medi-Cal enrollment data grouped by total enrollment, sex, age group, region, county, language, and race/ethnicity.
Medi-Cal Certified Eligibles Data by Month with Demographics
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These files contain monthly data by county for Medi-Cal certified eligibles, by various demographics traits. The data is split out and not distributed as a single dataset for the purposes of de-identification.
Covered California Enrollees by Rating Region
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This dataset includes the number of eligible individuals selected and enrolled in a Covered California qualified health plans (QHPs) by rating region and by reporting period. California is comprised of 19 rating regions, and each region has different pricing and health insurance options. Covered California reported data is from the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) and includes eligible individuals who selected and enrolled in a QHP, and paid their first premium. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.
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