Can I keep my doctor on Medi-Cal?

Asked by: Naomie Goldner  |  Last update: October 4, 2023
Score: 4.6/5 (44 votes)

If your doctor agrees to keep seeing you as a patient and will work with your new Medi-Cal managed care plan, you may be able to continue seeing your doctor for up to 12 months. Be sure to read the Frequently Asked Questions for more detailed information about this or contact your Medi-Cal managed care health plan.

How much can you make and stay on 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.

What disqualifies you from Medi-Cal?

Medicaid income eligibility in California is based on household size. To qualify for free Medi-Cal coverage, you need to earn less than 138% of the poverty level, based on the number of people who live in your home.

Do I have to re enroll in 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. Want to get started with Covered California?

Does Medi-Cal cover all bills?

Medi-Cal covers most medically necessary care. This includes doctor and dentist appointments, prescription drugs, vision care, family planning, mental health care, and drug or alcohol treatment. Medi-Cal also covers transportation to these services. Read more in “Covered Benefits” on page 12.

The Importance of Properly Terminating Medi-Cal

21 related questions found

What are full benefits under Medi-Cal?

​​​​What are the Medi-Cal Benefits? ​​Medi-Cal currently provides a core set of health benefits, including doctor visits, hospital care, immunization, pregnancy-related services and nursing home care. The Affordable Care Act ensures all Medi-Cal health plans offer what are known as Essential Health Benefits (EHB).

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.

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.

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.

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.

Is Medi-Cal free?

Medi-Cal offers free or low-cost health coverage for California residents who meet eligibility requirements. Most applicants who apply through Covered California and enroll in Medi-Cal will receive care through managed health plans.

Is Medi-Cal income based?

If your income is below the MCAP eligibility guidelines, you may qualify for ​no-cost Medi-Cal. ​ If you do not qualify for MCAP because your income for your family size is below the MCAP eligibility guidelines, you may qualify for no-cost Medi-Cal.

What is the Medi-Cal Pickle Program?

The Pickle Amendment to section 503 of Public Law 94-566 of 1976 established a category of Medicaid eligibility for persons who may have lost eligibility to Supplemental Security Income due to a Social Security Title II Cost of Living Adjustment.

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.

Are college students eligible for Medi-Cal?

Students can opt out of their student health plans and purchase coverage through Covered California. Depending on income, students may receive tax credits to help pay for a private health plan through Covered California or receive low- or no-cost coverage through Medi-Cal.

What is the highest income to qualify for Medicaid?

Federal Poverty Level thresholds to qualify for Medicaid

The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. In 2023 these limits are: $14,580 for a single adult person, $30,000 for a family of four and $50,560 for a family of eight.

What happens if you don't report income to Medi-Cal?

If you do not report changes to your personal information right away, and then receive Medi-Cal benefits that you do not qualify for, you may have to repay DHCS.

What happens when you cancel Medi-Cal?

Once your Medi-Cal coverage is discontinued, you only have 60 days from the date it ends to start new health insurance. Unless you're getting health insurance through work, start a new plan as quickly as possible. To avoid being uninsured for any period of time, your new plan must start before your Medi-Cal plan ends.

Does Medi-Cal cover emergency room visits?

In the event you have a medical emergency before you find a doctor, contact 9-1-1 or go to the emergency room at your nearest hospital. Medi-Cal does cover emergency services for enrolled members, and if you show your BIC to emergency room staff, Medi-Cal will pay for the services you receive.

What are the different types of Medi-Cal?

​​​Find Out More About Medi-Cal Programs​​​
  • Medi-Cal Dental Program. Dental services are currently provided as one of the many benefits under the Medi-Cal program.
  • Fair Hearing. ...
  • Health Insurance Premium Payments. ...
  • Medi-Cal. ...
  • Medi-Cal Eligibility. ...
  • Medi-Cal Estate Recovery. ...
  • Medi-Cal Managed Care.

What's the difference between Medicaid and Medi-Cal?

Medi-Cal is what we call the joint Federal-State Medicaid program in California (just like Covered California is what we call Obamacare in California). Medi-Cal and Medicaid are essentially the same thing.

Can I change my Medi-Cal plan?

Can I change my Medi-Cal health plan? Yes. If you are in a Medi-Cal health plan and want to choose another health plan for any reason, you may leave the health plan and join a different health plan.