Do I have to pay for Medicare if I have Medi-Cal?

Asked by: Erick Harber  |  Last update: July 2, 2025
Score: 4.5/5 (26 votes)

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.

Does Medi-Cal pay for Medicare?

There are four Medi-Cal programs that pay for Medicare premiums, copayments, or deductibles. These programs are known as Medicare Savings Programs, Medicare Premium Payment Pro- grams, or Medicare Buy-Ins.

Can I have both Medicare and 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.

How do you qualify for free Medicare?

You're eligible for Part A at no cost at age 65 if 1 of the following applies: You receive or are eligible to receive benefits from Social Security or the Railroad Retirement Board (RRB). Your spouse (living or deceased, including a divorced spouse) receives or is eligible to receive Social Security or RRB benefits.

Can I avoid paying Medicare?

People who have to pay a premium for Part A may consider delaying enrollment to avoid the expense. Part A charges a penalty for late enrollment, though. An alternative in this case is to get a Marketplace plan instead of Medicare.

Do You Need Medicare If You Have Employer Health Insurance?

19 related questions found

Does everyone pay $170 for Medicare?

If you don't get premium-free Part A, you pay up to $518 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($185 in 2025).

Can you be exempt from paying Medicare?

Employees who have been in continuous employment with the employer since March 31, 1986, who are not covered under a Section 218 Agreement nor subject to the mandatory Social Security and Medicare provisions, remain exempt from both Social Security and Medicare taxes, provided they are members of a public retirement ...

What happens if you can't afford Medicare?

Depending on your state and how you qualify, Medicaid can cover some of your health care and certain Medicare costs, such as premiums, copays, coinsurance and deductibles. If you are eligible for full Medicaid coverage, you also automatically qualify for Extra Help for Medicare Part D coverage.

Is Medicare free at age 65?

Premium-Free Medicare Part A Based on Age

To be eligible for premium-free Part A on the basis of age: A person must be age 65 or older; and. Be eligible for monthly Social Security or Railroad Retirement Board (RRB) cash benefits.

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.

Do I need Medicare if I have Medicaid?

People who qualify for both Medicare and Medicaid are called “dual eligible.” If you're dual eligible, your Medicaid and Medicare plan(s) will work together to provide coverage for your needs. In most cases, Medicare will be your primary plan and cover most Medicare-eligible healthcare services.

What is the 3 month rule for Medi-Cal?

You may request Medi-Cal to pay retroactively for the three months prior to the month in which you apply.

Do you have to pay for Medicare if you have Medi-Cal?

Medicare Part B Buy-In Agreement

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.

How do Medicare and Medi-Cal work together?

People who qualify for both Medicare and Medi- Cal are commonly called “dual eligibles” or “Medi-Medis.” If you have both Medicare and Medi-Cal but no other insurance, Medicare pays first and Medi-Cal pays second.

How to get $800 back from Medicare Part B?

Medicare Part A and Part B know they can get up to $800 back

All the member has to do is provide proof that they pay Medicare Part B premiums. Each eligible active or retired member on a contract with Medicare Part A and Part B, including covered spouses, can get their own $800 reimbursement.

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 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 highest income to qualify for Medicaid 2024?

Parents of Dependent Children: Income limits for 2024 are reported as a percentage of the federal poverty level (FPL). The 2024 FPL for a family of three is $25,820. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2024 FPL for an individual is $15,060.

Can I choose not to pay Medicare?

You do not have to pay for Medicare Part B to keep Medi-Cal. Stopping Medicare Part B coverage is generally not recommended. If you want to talk to someone about stopping Medicare Part B, call the SSA at 1-800-772-1213. NOTE: A few things could happen if you do not pay your Medicare Part B premium.

Why do some people pay nothing for Medicare?

Costs for Part A (Hospital Insurance)

$0 for most people (because they paid Medicare taxes long enough while working - generally at least 10 years). This is sometimes called “premium-free Part A.” Do I qualify? If you don't qualify for a premium-free Part A, you might be able to buy it.

Do I have to pay for Medicare if I have no income?

Californians with an annual income of less than $20,121 for an individual or $27,214 for a couple are eligible for a Medicare Savings Program. These programs provide help from the State of California to pay for your Medicare premiums, and sometimes your deductibles and copayments.

Can you opt out of paying Medicare?

Yes, you can choose to opt out of Medicare coverage, but it's important to consider potential drawbacks. Medicare offers essential healthcare benefits, and opting out might leave you without coverage for certain medical expenses.

Do I need Medicare Part D if I have Medi Cal?

Dual eligible clients are those clients who have Medi-Cal and Medicare. It is mandatory for dual eligible/Medi-Medi clients to be enrolled with Medicare Part D.