Can you have Medi-Cal and private insurance at the same time?
Asked by: Danny Jast Sr. | Last update: June 2, 2025Score: 4.2/5 (65 votes)
What happens if you have Medi-Cal and private insurance?
Under federal law, your private health insurance must be billed first before billing Medi-Cal. Medi-Cal may be billed for the balance, including your other plans co-payments, co-insurance and deductibles.
Can you have Medi-Cal assistance and private insurance?
You can have Medicaid and private health insurance at the same time, and there are some advantages and disadvantages to doing so. In many cases, if you're eligible for both Medicaid and private insurance, your private insurance plan will be the primary coverage, and your Medicaid coverage will be supplemental.
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.
Can you have Medi-Cal and employer health insurance at the same time?
Yes, it's possible! Explore your options for keeping Medi-Cal when you're employed — or transitioning to an affordable health plan — and how Covered California can help.
Implementing Medi-Cal and Private Insurance Coverage in California
Can I have Medi-Cal and other health insurance?
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 2 Medi-Cal insurances at the same time?
Can I have 2 health insurance plans at the same time? Yes. A process called coordination of benefits determines which insurance plan will pay first. Your primary plan will pay for the health claim first, paying the costs up to the plan's coverage limits, and then your second plan will kick in.
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.
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.
What are the new rules for Medi-Cal in 2024?
On January 1, 2024, Medi-Cal eliminated any asset limit for enrollees and instead considers only applicants' income when assessing financial eligibility for benefits.
What happens if you have Medicaid and private insurance?
Eligibility is based on many factors that vary state by state with a common goal of providing benefits to low-income individuals and families that need it most. Because Medicaid eligibility is significantly based on income level, having private insurance will not restrict Medicaid benefits.
What is the highest income to qualify for Medi-Cal?
You are 19-64 years old and your family's income is at or below 138% of the Federal Poverty Level (FPL) ($21,597 for an individual; $44,367 for a family of four).
Can you have dual coverage with Medi-Cal?
Medicare Medi-Cal Plans (MMPs or Medi-Medi Plans)
When dual eligible beneficiaries choose a Medicare plan that is an MMP, they are automatically enrolled in the Medi-Cal plan that aligns with their Medicare plan, so there is one organization coordinating care across both sets of benefits.
How can you lose Medi-Cal?
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.
What does secondary insurance mean?
Secondary insurance is health insurance that pays after primary insurance on a claim for medical or hospital care. It usually pays for some or all of the costs left after the primary insurer has paid (e.g., deductibles, copayments, coinsurances).
Is it illegal to pay out of pocket if you have health insurance?
This means that it is not illegal to not use your health insurance for medical services. Medicare patients may have different requirements. Patients can elect to pay for medical services if they find it in their best interest to pay for them directly.
How does Medi-Cal know your income?
To qualify for Medi-Cal, you must live in the state of California and meet certain rules. You must give income and tax filing status information for everyone who is in your family and is on your tax return. You also may need to give information about your property.
Will I lose my Medicaid if I get Medicare?
People who have both Medicare and full Medicaid coverage are “dually eligible.” Medicare pays first when you're a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have.
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 I have insurance and Medi-Cal?
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.
Does Medi-Cal check savings?
As of January 1, 2024, all income-eligible people are able to access Medi-Cal's Aged and Disabled program, Medicare Savings Programs, and Long-Term Care programs regardless of assets. California is the first state in the nation to eliminate its asset test for ALL Medi-Cal programs.
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.
Is being double insured worth it?
Assuming Dual Coverage Is Always Better: While dual coverage can be beneficial, it's not always the best option for every situation. Don't assume that having two plans will automatically save you money. Evaluate the costs, coverage, and your specific healthcare needs to determine if dual coverage is cost-effective.
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.
Can you have Medicaid and employer insurance at the same time?
It is possible for Medicaid beneficiaries to have one or more additional sources of coverage for health care services.