Does Medi-Cal have a deductible?

Asked by: Hiram Green  |  Last update: February 11, 2022
Score: 4.2/5 (12 votes)

Medi-Cal with a Share of Cost (SOC)
An SOC functions like a deductible. You must pay this amount in any month you incur medical costs. After your SOC is paid, Medi-Cal will pay the remaining amount of your medical bills for that month.

Does Medi-Cal have copays?

For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. ... In general, individuals in Medi-Cal will get the same health benefits available through Covered California at a lower cost.

How do I lower my Medi-Cal share of cost?

You will need to submit evidence of the insurance purchase to Medi-Cal and request that they do a recalculation to eliminate your share of cost. Keep copies of all documentation and follow up.

What are the benefits of Medi-Cal?

​​​What are the Medi-Cal Benefits?
  • 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.

How much is Medi-Cal per month?

How much are the premiums? The premiums for Medi-Cal for Families are $13 for each child and no more than $39 per family per month. What can I do if I disagree with paying a monthly premium? Monthly premiums must be paid for the child(ren) to remain eligible for this Medi-Cal program.

Understanding Medi-Cal

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Can you have Covered California and Medi-Cal at the same time?

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.

Is Medi-Cal Covered California?

Medi-Cal offers low-cost or free health coverage to eligible Californian residents with limited income. Covered California is the state's health insurance marketplace where Californians can shop for health plans and access financial assistance if they qualify for it.

How much money can you have in the bank and still qualify for Medi-Cal?

You may have up to $2,000 in assets as an individual or $3,000 in assets as a couple. Some of your personal assets are not considered when determining whether you qualify for Medi-Cal coverage.

What is full scope Medi-Cal?

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 is the difference between Medi-Cal and Medicare?

Medicare provides health coverage to individuals 65 and older or those with a severe disability regardless of income, whereas Medi-Cal (California's state-run and funded Medicaid program) provides health coverage to those families with very low income, as well as pregnant women and the blind, among others.

What is the income limit for Medi-Cal 2021?

Adults are eligible for Medi-Cal if their monthly income is 138 percent or less of the FPL. For dependents under the age of 19, a household income of 266 percent or less makes them eligible for Medi-Cal. A single adult can earn up to $17,775 in 2021 and still qualify for Medi-Cal.

How does Medi-Cal share of cost work?

“Share of Cost” is the amount you agree to pay for health care before Medi-Cal starts to pay. ... You only need to meet your Share of Cost in the months that you get health care services. After you meet your share of cost, Medi-Cal pays for your care the rest of that month.

Why is my Medi-Cal bill so high?

Health care costs are growing faster than the economy, and a big portion of those bills is paid by employers and those with commercial insurance coverage. ... Health care costs are growing faster than the economy, and a big portion of those bills is paid by employers and those with commercial insurance coverage.

Does Medi-Cal check your bank account?

Yes. Asset tests are a part of Medicaid eligibility requirements. Medi-Cal is the State of California's Medicaid program. Bank accounts are one of the easier tests for the government to make.

Does Kaiser accept Medi-Cal?

Kaiser Permanente participates in Medi-Cal in many counties. This means that, if you are a current Kaiser Permanente member and your situation changes, you may be able to keep your same doctor and continue your care with Kaiser Permanente if you qualify for Medi-Cal.

How do I report changes to Medi-Cal?

For Medi-Cal, you must report it within 10 days. To report changes, call Covered California at (800) 300-1506 or sign in to your online account. You can also find a Licensed Insurance Agent, Certified Enrollment Counselor or county eligibility worker who can provide free assistance in your area.

Does Medi-Cal cover hospitals?

Medi-Cal is a program that pays medical expenses for people with low income. If you meet the requirements of the program, Medi-Cal will help pay for doctor visits, hospital stays, prescription drugs, rehabilitation, and other medical services. ...

What does limited Medi-Cal?

Adults age 19 or older may qualify for limited Medi-Cal benefits even if they do not have a Social Security Number (SSN) or cannot prove their immigration status. These benefits cover emergency, pregnancy-related and long-term care services.

Does Medi-Cal cover beds?

Durable Medical Equipment (DME) under the Medi-Cal program includes equipment such as basic and custom wheelchairs, canes, crutches, walkers, grab bars, hospital beds, water or gel pressure mattresses, oxygen therapy equipment, augmentative communication devices and other devices.

What assets are exempt from Medi-Cal?

This includes clothing, heirlooms, weddings and engagement rings, and other jewelry with a net value of under $100. Household items. IRAs, KEOGHs, and other work-related pension plans. These funds are exempt if the family member whose name it is in does not want Medi-Cal.

Can Medi-Cal take your house?

I. Can the State Take My Home If I Go on Medi-Cal? The State of California does not take away anyone's home per se. ... For example, your home may be an exempt asset while you are alive, and not counted for Medi-Cal eligibility purposes.

Do you have to repay Medi-Cal after your income increases?

Many of these people fear they will have to repay Medi-Cal for the months they were really ineligible for the no cost health insurance. Do you have to repay Medi-Cal after your income increases and you were no longer eligible? The short answer is usually not.

Is Medi-Cal a marketplace insurance?

Enrollment. Covered California is the new marketplace for affordable, low cost and no cost health insurance, including Medi-Cal. It's a “no wrong door” approach that will help Californians learn their eligibility for subsidized health benefits, compare insurance plan options, and enroll to receive coverage.

Can I stay on Covered California after 65?

Thank you for choosing health insurance through Covered California. Our records indicate that you or someone in your family may qualify for Medicare because you are, or will soon be, age 65 or older. If you have a Covered California plan with financial assistance, you can keep it until you qualify for Medicare.

Do I need to cancel Medi-Cal?

When you apply for medical coverage through Covered California, you're automatically evaluated for Medi-Cal. ... You don't actually have to do anything to cancel Medi-Cal, but if you want to end your coverage immediately, you can withdraw your application.