Can you have double Medi-Cal coverage in California?

Asked by: Otha Jakubowski  |  Last update: February 5, 2025
Score: 5/5 (7 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.

Can you be double covered with Medi-Cal?

You can have Medi-Cal even though you have Other Health Coverage (OHC) through individual or group private health (or dental) insurance coverage. See the email we rec'd May 17th from Medi Cal to clarify some of these issues. Read the rest of the page on which plan pays first, etc. namely, the other plan.

Can you have two health insurances Covered California?

In California, qualified group health insurance plans co-ordinate benefits with each other. This means that you can get coverage under your health plan and additional sharing of claims cost under your spouse's group plan if you are enrolled on both.

Who is dual eligible for Medi-Cal?

While there are several ways to qualify for Medi-Cal, this section focuses only on Medi-Cal beneficiaries who also qualify for Medicare — individuals who are over a certain age and/or disabled. People who qualify for both Medicare and full Medi-Cal are known as “dual eligibles” or “Medi-Medis.”

Is there a limit to 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 do I qualify for Medi-Cal in California?

34 related questions found

What are the new rules for Medi-Cal 2024?

Basic Information. Beginning January 1, 2024, a new law in California will allow adults ages 26 through 49 to qualify for full-scope Medi-Cal, regardless of immigration status. All other Medi-Cal eligibility rules, including income limits, will still apply.

How much money can I have in my bank account if I have Medi-Cal?

For new Medi-Cal applications only, current asset limits are $130,000 for one person and $65,000 for each additional household member, up to 10. Starting on January 1, 2024, Medi-Cal applications will no longer ask for asset information. » I was not eligible in the past.

How does dual Medi-Cal coverage work?

Having two health plans doesn't mean you'll receive full medical coverage twice. Instead, one policy will be your primary plan, and the other will be your secondary health coverage. This ensures the total amount your two plans will pay for your health expenses will never exceed 100% of the cost of those expenses.

How do I know if I am dual eligible?

According to the Centers for Medicare & Medicaid Services, you may qualify for dual eligible benefits if5: You are enrolled in Original Medicare (Part A, Part B, or both); and. Receive full Medicaid benefits; or. Get help with your Medicare out-of-pocket costs through a Medicare Savings Program (MSP)

Can I have both Covered California and Medi-Cal?

You can also call your local county office. Did you know? It is possible for members of the same family to qualify for both Medi-Cal and Covered California.

What does Medi-Cal not cover?

Restricted scope Medi-Cal covers limited services. It does not cover medicine or primary care. If you have pregnancy-related limited scope Medi-Cal, you will have the full scope of Medi-Cal benefits, if the service is medically necessary.

Can you have two health insurances with Medicaid?

The simple answer to the question of “can you have both Medicaid and private insurance?” is a resounding “YES”! Medicaid is given to low-income U.S citizens in need and will not be disputed due to already enrolled in a private health insurance program.

What is double insurance?

Double insurance refers to the method of getting insurance of same subject matter with more than one insurer or with same insurer under different policies. This means that one can get insurance policies on a subject matter more than its value. Double insurance is possible in all types of insurance contracts.

Which Medi-Cal plan is best?

OAKLAND, Calif., Jan. 19, 2023 – Kaiser Permanente Northern California's Medi-Cal health plan is the highest rated in the state for quality care, according to a December 2022 report from the state's Department of Health Care Services (DHCS).

Can I use my secondary insurance as primary?

The short answer is no, you can't. As outlined above, an individual's employer-sponsored plan will always be primary. Even if a spouse or parent's plan has better coverage or maybe a lower deductible, you can't submit claims to them first.

What happens if you make too much for Medi-Cal?

What can I do if I make too much money for Medi-Cal? You may get a private health plan through Covered California. You could also get financial assistance. If you qualify, your local Medi-Cal office will share your information.

Can you have dual coverage with Medi-Cal?

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 is a dual eligible Medi-Cal?

Dually Eligible Individuals – Categories. Revised 09/06/2024. People who are entitled to both Medicare and Medicaid, also known as dually eligible individuals, fall into several eligibility groups. These individuals may either be enrolled first in Medicare and then qualify for Medicaid or vice versa.

Does Medi-Cal pay Medicare premiums in California?

The State of California participates in a buy-in agreement with CMS, whereby Medi-Cal automatically pays Medicare Part B premiums for all Medi-Cal members who have Medicare Part B entitlement as reported by SSA.

Can I have Medi-Cal and private insurance?

(For Adults Age 19 and above, updated: June 2016) Myth 1: One can not have Medi-Cal and any other insurance at the same time. Fact: There are no restrictions on multiple coverage under Medi-Cal regulations.

Can you have two health insurances in California?

The short answer to that question is yes, you can have two health insurance plans. In fact, it's becoming increasingly common for individuals to have more than one health insurance plan.

What will disqualify you 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.

What is the new law for Medi-Cal in 2024?

Starting January 2024, all income-eligible Californians may qualify for full-scope Medi-Cal regardless of immigration status.

How much money can you have in the bank if you're on Medicare?

There is no limit on the amount of cash you can have with Medicare Part A. You do have to have paid taxes for 40 quarters (10 years) during your working lifetime and you have to be age 65 unless otherwise qualified due to a social security eligible disability.