Can I have Medi-Cal and private insurance?

Asked by: Ruthe Mante MD  |  Last update: February 11, 2022
Score: 4.2/5 (71 votes)

If you have private health insurance, you can still qualify for Medi-Cal. Members who already have insurance can add Medi-Cal coverage to their existing plan. Your provider will first bill your private insurance, and then Medi-Cal will pay for any additional services it covers.

Can I have Medi-Cal and private insurance at the same time?

If you have private health coverage and are eligible for Medi-Cal, you may qualify for the Medi-Cal/HIPP program, which can pay for your insurance premiums. When using private health coverage and Medi-Cal simultaneously, the private health coverage is billed first.

Can I have employer insurance and Medi-Cal?

Medi-Cal and Employer-Sponsored Health Coverage

Note: You can choose to get Medi-Cal even if you have employer-sponsored coverage. If you have both at the same time, Medi-Cal may decide it is cost-effective for them to pay your portion of your employer-sponsored health insurance's premium.

Is Medi-Cal primary or secondary insurance?

If you have both Medicare and Medi-Cal, Medicare is the primary payer (meaning Medicare will pay first for Medicare-covered benefits) and Medi-Cal is the secondary payer.

Do I have to pay back Medi-Cal?

The Medi-Cal program must seek repayment from the estates of certain deceased Medi-Cal members. Repayment only applies to benefits received by these members on or after their 55th birthday and who own assets at the time of death. If a deceased member owns nothing when they die, nothing will be owed.

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19 related questions found

Does Medi-Cal check your bank account?

Yes. Asset tests are a part of Medicaid eligibility requirements. Medi-Cal is the State of California's Medicaid program. Bank accounts are one of the easier tests for the government to make.

How much is Medi-Cal per month?

How much are the premiums? The premiums for Medi-Cal for Families are $13 for each child and no more than $39 per family per month. What can I do if I disagree with paying a monthly premium? Monthly premiums must be paid for the child(ren) to remain eligible for this Medi-Cal program.

Can I pay out of pocket if I have Medi-Cal?

How much does Medi-Cal cost?​​​​ For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. ... In general, individuals in Medi-Cal will get the same health benefits available through Covered California at a lower cost.

Can you have Medi-Cal and Kaiser?

Kaiser Permanente participates in Medi-Cal in many counties. This means that, if you are a current Kaiser Permanente member and your situation changes, you may be able to keep your same doctor and continue your care with Kaiser Permanente if you qualify for Medi-Cal.

What is the difference between Medi-Cal and Covered California?

Medi-Cal offers low-cost or free health coverage to eligible Californian residents with limited income. Covered California is the state's health insurance marketplace where Californians can shop for health plans and access financial assistance if they qualify for it.

Does unemployment affect Medi-Cal?

For MAGI and Non-MAGI Medi-Cal, the federal supplemental unemployment benefit shall be disregarded and are not counted in the income eligibility determination. For Non-MAGI, PUC is counted as property if retained into the following month for the purposes of Non-MAGI Medi-Cal eligibility determinations.

Can You Get Covered California if you already have insurance?

You can still buy insurance through Covered California or through another insurer if that is cheaper than the insurance from your job, but you will not get help (“tax credits”) paying for it.

Can I use Medi-Cal in another county?

You may apply for Medicaid in the state you move to. If you are moving to a new county in California, you also need to tell the county you live in or the county you are moving to. This is to make sure you keep getting Medi-Cal benefits. You should tell your local county office within 10 days of moving to a new county.

How do copays work with two insurances?

Normally patients that come in with 2 insurances should not be charged a copay. In most cases their secondary policy will pick up the copay left from the primary insurance. ... We recommend you bill those particular patients after both insurances process the claim for any remaining copay.

Can you have Medicaid and private insurance at the same time 2021?

You can have both a Marketplace plan and Medicaid or CHIP, but you're not eligible to receive advance payments of the premium tax credit or other cost savings to help pay for your share of the Marketplace plan premium and covered services.

Does Scripps take Medi-Cal?

Please note that all Scripps hospitals accept Medi-Cal insurance. ... Scripps doctors and hospitals are also available through many individual or family insurance plans sold “off” the exchange in the private market. For more information, call 1-800-SCRIPPS (727-4777) or talk to your insurance agent or broker.

Can you see a Kaiser doctor without Kaiser insurance?

The program provides temporary financial assistance or free care to patients who receive health care services from our providers, regardless of whether they have health coverage or are uninsured. The program is one of the most generous in the health care industry and is available to those patients in greatest need.

Does Covered California offer Kaiser?

Covered California Kaiser plans are offered in all of California's 19 pricing regions. Kaiser is an “in-house” network which means medical services are provided by a Kaiser medical group, a Kaiser laboratory, a Kaiser pharmacy and a Kaiser hospital.

What disqualifies Medi-Cal?

If a person has more than the limit for a whole month, Medi-Cal benefits will be discontinued. A person's home, furnishings, personal items, and one motor vehicle are not counted. A single person is allowed to keep $2,000 in property/assets, more if they are married and/or have a family.

What is the income limit for Medi-Cal 2021 in California?

According to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income.

What does Medi-Cal pay in California?

In fiscal year 2019–20, Medi-Cal brought in more than $65 billion in federal funds and accounted for nearly 16% of all state general fund spending. People with disabilities composed 9% of Medi-Cal enrollees, but accounted for 31% of spending.

What is the Medi-Cal income limit for 2022?

In 2022, the MMMNA in CA is $3,435 / month. If a non-applicant spouse has monthly income under this amount, income can be transferred from the applicant spouse to the non-applicant spouse to bring their monthly income up to this level.

How many months of bank statements do I need for Medi-Cal?

Because of this look back period, the agency that governs the state's Medicaid program will ask for financial statements (checking, savings, IRA, etc.) for 60-months immediately preceeding to one's application date. (Again, 30-months in California).

Does Medi-Cal cover MRI scans?

MRI scans may be covered at 80%, leaving you to pay the remaining 20% of the costs associated with this procedure. To qualify for Medicaid payment, however, the scans must meet three important criteria: ... The MRI must be performed in a facility that also accepts payment from Medicaid and Medicare.

Does Quest Diagnostics accept Medi-Cal?

Does Quest Accept Medicaid? Quest Diagnostics is a private laboratory that offers blood work to many medical providers. ... In California, for example, Medicaid does pay for Quest services that fall within an approved package, such as prenatal services, H.