PCHS Eligibility

Personal Care and Home Supports (PCHS) is a Medi-Cal benefit that covers in-home care — at $0 out of pocket — for eligible members. Here's who qualifies and how to find out.

Requirements

Do You Qualify?

To be eligible for PCHS through CalAIM, a member must meet all of the following criteria.

Note: PCHS is not an automatic entitlement — your Managed Care Plan reviews each request and authorizes based on member need. If denied, you have the right to appeal through your plan's grievance process or request an Independent Medical Review (IMR).


Common Situations

Who Benefits Most from PCHS?

PCHS is especially useful in these circumstances:

Waiting for IHSS Approval

PCHS can be authorized while your IHSS application is pending — bridging the gap so care isn't delayed.

IHSS Hours Are Not Enough

If IHSS approved fewer hours than needed, PCHS can supplement those hours to fill in the rest.

Recently Discharged from Hospital or SNF

PCHS is often authorized as part of a discharge plan to support a safe return home.

Managing a Chronic Condition

Members with Alzheimer's, Parkinson's, ALS, TBI, or physical disabilities who require daily assistance are strong candidates.

At Risk of Placement in a Facility

If the lack of home support could lead to nursing home placement, MCPs often prioritize PCHS to help the member remain home.

Family Caregiver Is at Capacity

When an unpaid family caregiver is overwhelmed, PCHS provides professional support alongside Caregiver Respite authorization.


Next Steps

How to Access PCHS

Follow these steps to find out if PCHS is available to you and get the authorization process started.

  1. 1
    Locate your Medi-Cal card

    Your card shows your Managed Care Plan name. If it reads "Medi-Cal" without a plan name, call 1-800-541-5555 to confirm whether you're in managed care or fee-for-service.

  2. 2
    Call your plan's Member Services

    Ask: "Does my plan offer CalAIM Community Supports — specifically Personal Care and Home Supports (PCHS) — in my county?" Request written confirmation if possible.

  3. 3
    Ask your doctor or care team for a referral

    A primary care physician, specialist, or hospital discharge planner can submit a referral or request for PCHS through your Managed Care Plan. You can also ask to be connected with an Enhanced Care Management (ECM) Lead Care Manager.

  4. 4
    Contact Divine Agape

    We are a contracted PCHS provider. We can confirm whether we work with your plan and help you initiate the authorization process — at no cost to you.

  5. 5
    If denied, appeal

    You have the right to appeal any plan denial through your plan's grievance and appeals process. You may also request an Independent Medical Review through the California Department of Managed Health Care (DMHC) at 1-888-466-2219.

Already have IHSS? PCHS and IHSS can work together. PCHS can supplement existing IHSS hours or cover care tasks during periods when IHSS hours are reduced or pending reassessment. Learn about IHSS application support →


We Can Help You Get Started

Not sure if you qualify or which plan to contact? Reach out to Divine Agape — we'll review your situation, confirm our plan contracts, and walk you through the next steps at no cost.

Get Started Today CalAIM Overview