Can a person have Medicare and Medi-Cal at the same time?

Asked by: Mrs. Maddison Gottlieb I  |  Last update: September 16, 2023
Score: 4.8/5 (50 votes)

Some people qualify for both Medicare and Medi-Cal and are “dual eligible” or Medi Medi beneficiaries. When an individual has both Medicare Parts A and B, Medicare is the primary insurance and pays for most medical care.

What happens to Medi-Cal when I turn 65?

​​Basic Information​​ Beginning May 1, 2022, a new law in California will give full scope Medi-Cal to adults 50 years of age or older and immigration status does not matter. All other Medi-Cal eligibility rules, including income limits, will still apply.

Does Social Security income count for Medi-Cal?

Unearned Income

This type of income relates to interest on savings and retirement accounts, pensions, annuities, veteran's benefits, etc. Social Security counts as unearned income as well.

Does Medi-Cal cover more than Medicare?

Medi-Cal also provides additional benefits beyond what's usually included with Medicare Parts A and B, covering prescription drugs, dental, vision care, extended stays in skilled nursing facilities and long-term care in nursing homes.

Can you have Medi-Cal if you have other insurance?

Even if you have other health coverage such as health insurance from your work, you may still qualify for Medi-Cal. If you qualify, Medi-Cal will cover allowable costs not paid by your primary insurance. Under federal law, Medi-Cal beneficiaries' private health insurance must be billed first before billing Medi-Cal.

Unveiling the Secret Behind Dual Medicaid and Medicare Coverage – You Need to See This!

33 related questions found

Can you have double Medi-Cal coverage in California?

You can have two health insurance plans, but primary and secondary insurance rules apply, so you can't receive reimbursement for more than the total cost of your medical expenses.

What type of Medicare is Medi-Cal?

Medi-Cal is California's Medicaid health care program. Medi-Cal pays for a variety of medical services for children and adults with limited income and resources. Medicare is a federally funded insurance program for eligible participants 65 or over.

What are the income limits for full scope Medi-Cal?

You are 19-64 years old and your family's income is at or below 138% of the Federal Poverty Level (FPL) ($20,120 for an individual; $41,400 for a family of four). You are a child 18 or younger and your family's income is at or below 266% of FPL ($79,800 per year for a family of four).

Who pays more for Medicare?

If you have higher income, you'll pay an additional premium amount for Medicare Part B and Medicare prescription drug coverage. We call the additional amount the “income-related monthly adjustment amount.”

What is California Medi-Cal changing to in 2023?

Starting January 2023, Medi-Cal health coverage for most remaining dually eligible beneficiaries changed from Fee-For-Service (FFS) Medi-Cal to Medi-Cal Managed Care.

How does Medi-Cal check income?

The Modified Adjusted Gross Income (MAGI) Medi-Cal method uses Federal tax rules to decide if you qualify based on how you file your taxes and your countable income. Property rules: No property limits. Non-MAGI Medi-Cal includes many special programs.

What other benefits can I get with Medi-Cal?

​​​​What are the Medi-Cal Benefits?
  • Outpatient (Ambulatory) services.
  • Emergency services.
  • Hospitalization.
  • Maternity and Newborn care.
  • Mental Health and Substance Use Disorder Services​
  • Prescription Drugs.
  • Programs such as physical and occupational therapy (known as Rehabilitative & Habilitative Services) and devices.

What age does Medi-Cal stop?

All California residents under the age of 26 who meet the eligibility requirements can qualify to receive Medi-Cal, regardless of U.S. citizenship or immigration status.

How much can I make and still get Medi-Cal in California?

Most single individuals will qualify for Medi-Cal if there income is under $1,676 per month. Most couples will qualify if their income is under $2,267 per month. If you have disabilities, your income can be slightly higher. You can qualify for Medi-Cal even if you have assets.

What is changing in Medi-Cal in 2024?

Pending approval from the Centers for Medicare and Medicaid Services, beginning January 1, 2024, the second phase of this new law in California will eliminate the asset limit for all Non-MAGI Medi-Cal programs. Additional information about this change will be posted to this website at a future date.

What does full scope Medi-Cal mean?

Medi-Cal provides free or low-cost health care to some people who live in California. Full. scope Medi-Cal covers more than just emergency health care. It provides medical, dental, mental health, family planning and vision (eye) care.

Does Medi-Cal cover surgery?

medications. Inpatient hospital services • Anesthesiologist services • Surgical services (bariatric, reconstructive surgery, etc.) Organ & tissue transplantation • Outpatient laboratory and X-ray services o Various advanced imaging procedures are covered based on medical necessity.

What is the new name for Medi-Cal?

On January 1, 2023, Cal MediConnect plans transitioned to Medicare Medi-Cal plans (MMPs or Medi-Medi plans) provided by the same companies that provided Cal MediConnect plans.

What insurance company is Medi-Cal?

Medi-Cal is California's Medicaid program that provides medical services to low-income people at little or no cost. It is administered by the Centers for Medicare and Medicaid Services (CMS) and the California Department of Health Care Services (DHCS).

Will I lose my Medi-Cal if I get a job?

If you get Medi-Cal coverage and then get a job, you have a couple of options for keeping your Medi-Cal benefits. If you got Supplemental Security Income (SSI) cash benefits before you got your job, Social Security's 1619(b) program lets you earn up to $56,758 annually and still keep Medi-Cal coverage at no cost.

Do you have to apply for Medi-Cal every year?

Medi-Cal members must renew their coverage each year to keep their health care benefits. For most members, coverage is renewed automatically. Sometimes the county will send you a renewal form that you must review and return, along with any additional required information.

Can you own a home and get Medi-Cal in California?

Property used as a home is exempt (not counted in determining eligibility for Medi-Cal).