Can you get Medi-Cal if you have insurance?
Asked by: Hank Nikolaus | Last update: October 7, 2023Score: 4.4/5 (1 votes)
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.
Can you have Medi-Cal and work insurance at the same time?
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.
What disqualifies me from Medi-Cal?
The Medi-Cal program determines eligibility for benefits on a “means” tested basis. If a Medi-Cal applicant's property/assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property/assets according to the program rules.
Can anyone qualify for Medi-Cal?
Medi-Cal gives people with low incomes access to health services, including medical and dental care. The program is available for adults, children, pregnant women, older adults and people with disabilities. People who have certain conditions, such as tuberculosis and HIV, might also qualify for Medi-Cal.
Can you be denied Medi-Cal?
If you don't apply for or keep no-cost health coverage or state-paid coverage, your Medi-Cal benefits and eligibility will be denied or stopped. 11. If you do not give necessary information or if you give information that you know is false, your Medi-Cal benefits may be denied or stopped.
Medi-Cal Eligibility Updates for 2023
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.
How long does it take to qualify for Medi-Cal?
The process for verifying your Medi-Cal eligibility, from the time your completed application is received to when you receive your Benefits Identification Card (BIC), normally takes 45 days.
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.
How do you qualify for straight Medi-Cal?
- 65 or older.
- Blind.
- Disabled.
- Under 21.
- Pregnant.
- In a skilled nursing or intermediate care home.
- On refugee status for a limited time, depending how long you have been in the United States.
- A parent or caretaker relative of an age eligible child.
Can Medi-Cal be secondary insurance?
Families who already have health insurance coverage for their child can still benefit from Medi-Cal (California's Medicaid program), which may be used as secondary insurance to pay for certain expenses that primary health insurance doesn't cover.
Can I choose Covered California instead of Medi-Cal?
You may be eligible for health coverage through Covered California if you are no longer eligible for Medi-Cal due to an income increase or change in household size. In order to avoid a gap in your health coverage, Covered California can help you select a new plan before your Medi-Cal coverage ends.
Can you have Covered California and Medi-Cal?
These two-program families are called “mixed-program families.” Your family can apply for both through Covered California application. Individuals in a mixed-program family will face different, but typically lower, costs due to their eligibility for both Covered California and Medi-Cal.
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 other benefits can I get with Medi-Cal?
- 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 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 much is Medi-Cal monthly?
Medi-Cal monthly premium amounts have been reduced to $0.00 effective July 1, 2022. Monthly billing and collection of premiums for the Medi-Cal for Families program will no longer be required.
Does Blue Shield have a Medi-Cal plan?
Blue Shield of California Promise Health Plan currently serves Medi-Cal members in Los Angeles and San Diego counties. In Los Angeles County, we are contracted with L.A. Care Health Plan. In San Diego County, we are contracted with the Department of Health Care Services.
How much does Medi-Cal cost California?
For most families, Medi-Cal coverage for kids is free, with no premium, deductible or copays. For CCHIP coverage and sometimes for Medi-Cal, there is a fee of $13 per month per child, up to $39 per family. Want to get started with Covered California?
Does Medi-Cal start immediately?
Once your Medi-Cal eligibility is confirmed, the health coverage is effective beginning the first day of the month when you applied.
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.
How often do you have to apply for Medi-Cal?
If I already have Medi-Cal benefits, do I need to reapply? No. If you already have Medi-Cal coverage, your Medi-Cal benefits will continue until your next regularly scheduled annual redetermination date. Your local county will contact you to get any updated information they need.