Do you have to pay monthly for Medi-Cal?

Asked by: Dr. Casper Kessler  |  Last update: December 5, 2023
Score: 4.2/5 (27 votes)

​How much does Medi-Cal cost?​​​​ For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost.

Do you pay monthly for Medi-Cal?

Medi-Cal monthly premium amounts have been reduced to $0.00 effective July 1, 2022. Monthly billing and collection of premiums for the Optional Targeted Low Income Children's Program (OTLICP), formally known as Medi-Cal for Families program, will no longer be required.

How does Medi-Cal calculate monthly income?

All available income is factored into the monthly income and Medi-Cal eligibility is based on monthly income. If a person receives income weekly or biweekly, that income is multiplied to figure out the monthly amount.

Do you have to pay back Medi-Cal benefits?

The Medi-Cal program must seek repayment from the estates of certain deceased Medi-Cal beneficiaries. Repayment only applies to benefits received by these beneficiaries on or after their 55th birthday and who own assets at the time of death. If a deceased beneficiary owns nothing when they die, nothing will be owed.

How much do you have to make to receive 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.

Medi-Cal Eligibility Updates for 2023

29 related questions found

What is the monthly income for Medi-Cal in California?

If it is less than $1,677 for individuals or $2,268 for a couple, then you qualify for free, full scope Medi-Cal based on A&D FPL rules. If it is higher than $1,677 for individuals, you may qualify for Medi-Cal's Working Disabled Program or ABD-MN Medi-Cal instead.

Who pays for Medi-Cal in California?

Medi-Cal is California's Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes.

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 copays?

Medi- Cal may pay for any co-pays or deductibles you accrue under your private health insurance coverage, Medicare Part A (in-patient hospital), Medicare Part B (out-patient services, including specialty care and lab tests), Veterans Insurance, Tricare or any other public or private insurance plan that allows for such ...

What does full Medi-Cal cover?

Medi-Cal provides free or low-cost health care for some people who live in California. Full scope Medi-Cal covers more than just care when you have an emergency. It provides medical, dental, mental health, and vision (eye) care. It also covers alcohol and drug use treatment, drugs your doctor orders, and more.

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.

Does Medi-Cal look at your savings account?

Medi-Cal limits seniors and people with disabilities to assets of no more than $2,000 for individuals and $3,000 for couples — a restriction that has not changed since 1989. Assets include cash on hand, money in a checking or savings account, a second car, and other resources.

How many cars can you own on Medi-Cal?

ONE car. Insurance policies. Whole life (if total face value is $1,500 or less) and term life.

What is regular Medi-Cal?

Medi-Cal is California's Medicaid program. This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources.

Do you have to pay back Medi-Cal in California?

Do you have to pay back California Medicaid? The Medi-Cal program is required to seek repayment from the estates of certain deceased Medi-Cal members. The rules state that repayment only applies to the benefits received by members on or after their 55th birthday and who owned assets at the time of death.

Can you own a home and get Medi-Cal in California?

Property used as a home is exempt (not counted in determining eligibility for Medi-Cal).

Is Medi-Cal reported on taxes?

Yes, DHCS is responsible for reporting any month(s) of Medi-Cal coverage that meets the requirement for MEC to the IRS and Franchise Tax Board (FTB). DHCS must also provide a Form 1095-B to all people whose coverage was reported to the IRS and FTB. The form you will get will show which months you had MEC.

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.

Is Medi-Cal and Medicaid the same?

Medi-Cal is the same as Medicaid in California. It is a Federal and state-supported form of insurance that pays for various medical services for California residents with limited income and resources.

Can I get Covered California if I have a job?

You may have coverage as a current worker or retiree. You can shop for health coverage through Covered California, but you won't qualify for financial help in the form of premium tax credits if your employer offers a health plan that meets minimum value standards and is considered affordable.