Can I go to any er if I have Medi-Cal?
Asked by: Isaac Padberg | Last update: January 2, 2026Score: 4.3/5 (53 votes)
Can I go to any ER regardless of insurance?
In a true emergency, go straight to the hospital. Insurers can't require you to get prior approval before getting emergency room services from a provider or hospital outside your plan's network.
How much is an ER visit with Medi-Cal?
Emergency hospital services $0 copay for Medicaid- covered services 56. Transportation (State provides emergency and non-emergency medical transportation. Meets federal requirement for assurance of transportation to medically necessary services) $0 copay for Medicaid- covered services .
Can you go to any doctor if you have Medi-Cal?
Once you are enrolled in a Medi-Cal health plan, you need to choose a primary care doctor who works with your Medi-Cal health plan. You can ask your current doctor if they work with a Medi-Cal health plan in your county.
Do all emergency rooms accept Medicaid?
One common question that arises is whether emergency rooms accept Medicaid. The answer is generally yes; most emergency rooms across the United States are required to treat patients regardless of their insurance status, including those with Medicaid.
When should I go to the ER for my medical condition?
Can I go to any ER with Medi-Cal?
Emergency Rooms: As stated above, if you have an emergency and you cannot find a doctor right away, you can go to the emergency room at any hospital. If you show your BIC to staff at the emergency room, Medi-Cal will pay for the services you receive.
Does California Medi-Cal cover out of state emergencies?
As long as you qualify, Medi-Cal will cover emergency services and urgent care in another state. If L.A. Care approves the service and the doctor and hospital meet Medi-Cal rules, Medi-Cal will also cover emergency care that requires hospitalization in Canada and Mexico.
What is the disadvantage of Medi-Cal?
The perception that Medi-Cal offered poorer coverage or less respectful treatment than other types of insurance. Concerns among noncitizen respondents that applying for Medi-Cal might affect their immigration status.
What are the restrictions for Medi-Cal?
If you apply for Medi-Cal in 2023:
The current asset limit is $130,000 for one person. Each additional household member adds $65,000 to the asset limit. Up to 10 members can be in a household. Medi-Cal will also consider income information (including income from property).
Can you go to Kaiser with Medi-Cal?
Kaiser Permanente is an active participant in Medi-Cal managed care and our Fee-for-Service program provides care to Medi-Cal beneficiaries who are not Kaiser Permanente members but who may find it necessary to receive emergency care at one of our facilities.
Is ER cheaper than urgent care?
An urgent care visit is between $100 and $200 – about ten times less than the average ER visit. If you have insurance, it should only be the cost of your co-pay. Most urgent care clinics are open 7 days a week. And, on average, wait times are 30 minutes or less.
Does Medi-Cal cover an ambulance?
Medi-Cal covers ambulance and non-emergency medical transportation (NEMT) only when ordinary public or private conveyance is medically contra-indicated and transportation is required for obtaining needed medical care. Non-medical transportation (NMT) is used for a recipient to obtain covered Medi-Cal services.
What does Medicaid not cover?
Though Medicaid covers a wide range of services, there are limitations on certain types of care, such as infertility treatments, elective abortions, and some types of alternative medicine. For example, the federal government lists family planning as a mandatory service benefit, but states interpret this differently.
How much do most ER visits cost?
Average ER visit cost
An ER visit costs $1,500 to $3,000 on average without insurance, with most people spending about $2,100 for an urgent, non-life-threatening health issue. The cost of an emergency room visit depends on the severity of the condition and the tests, treatments, and medications needed to treat it.
Do you have to pay upfront at the ER?
Patients may be responsible for paying the entire cost of their emergency room visit out of pocket. This includes the upfront expenses incurred during the visit. Yet it also includes any subsequent bills for follow-up care or services provided.
Why would insurance deny an ER visit?
According to section 1371.4 of the California Health and Safety Code, coverage of ER visits can only be denied if it is shown the patient “did not require emergency services care and the enrollee reasonably should have known that an emergency did not exist.” The California rule does not rely on a fictitious “prudent ...
Do all doctors accept Medi-Cal?
Not necessarily. Doctors can refuse to take Medi-Cal patients. Before receiving treatment, check whether the provider accepts Medi-Cal Fee-For-Service payments to avoid having to pay out of pocket.
Why does no one accept Medi-Cal?
The most frequent reasons physicians limit Medi-Cal patients in their practices are payment rates and administrative hassles.
How do I get an emergency Medi-Cal?
1 – Go to the emergency room. If you are experiencing a true medical emergency, where your only choice is to go straight to the nearest hospital, then go. The hospital will provide you with the health care you need. Then, the hospital's billing department will assist you in applying for emergency Medi-Cal benefits.
What disqualifies you from Medi-Cal?
To qualify, you must: Meet the medical requirements of Social Security's definition of disability. Be working and earning income (this can be part-time work). Have countable income less than 250% of the federal poverty level (in 2024, this equates to $3,158/mo.
How much income is too much for Medi-Cal?
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.
Why did my Medi-Cal get cancelled?
Your Medi-Cal coverage will end if you don't turn in your renewal form or you are missing proof of things like income that the county asked you to send. Your local Medi-Cal office will mail you a letter (Notice of Action) to let you know if you didn't turn in your renewal form or are missing information.
How much is an ER visit without insurance in California?
On average, an emergency room visit in California can range anywhere from $150 to over $3,000. This variation is influenced by the facility's location, the complexity of the treatment required, and the presence of additional diagnostic tests.
What happens if you go to the ER without insurance?
If you have a serious medical problem, hospitals must treat you regardless of whether you have insurance. This includes situations that meet the definition of an emergency. Some situations may not be considered true emergencies, such as: Going to the ER for non-life-threatening care.
When should you not go to the emergency room?
When Should You Not Go to the ER? If your condition or injury requires professional care, but will not get worse if not immediately treated, you can hold off on the ER visit and make an appointment to see your primary care physician or visit a walk-in care center.