Is Medi-Cal a state plan?

Asked by: Christine Hill  |  Last update: January 15, 2024
Score: 5/5 (12 votes)

​California's Medicaid State Plan
The Medicaid State Plan is based on the requirements set forth in Title XIX of the Social Security Act and is a comprehensive written document created by the State of California that describes the nature and scope of its Medicaid (Medi-Cal) program.

Is Medi-Cal a state insurance?

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.

What type of insurance is Medi-Cal?

Medi-Cal is California's version of the Federal Medicaid program. Medi-Cal offers no-cost and low-cost health coverage to eligible people who live in California. The Department of Health Care Services (DHCS) oversees the Medi-Cal program. Your local county office manages most Medi-Cal cases for DHCS.

Is Medi-Cal state or federal?

Medi-Cal is a public health insurance program for low-income Californians. Medi-Cal—California's Medicaid program—is a state-federal program that offers free or low-cost health coverage to Californians with low family incomes.

Is Medi-Cal a state marketplace plan?

Covered California is the new marketplace that makes it possible for individuals and families to get free or low- cost health insurance through Medi-Cal, or to get help paying for private health insurance.

What Is Medi-Cal? (Part 1)

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Is Medi-Cal a Medicare plan?

Medi-Cal is California's Medicaid health care program. Medi-Cal pays for a variety of medical services for children and adults with limited income and resources. Medicare is a federally funded insurance program for eligible participants 65 or over.

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.

What are Medi-Cal State benefits?

​​​​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).

What is the new name for Medi-Cal?

On January 1, 2023, Cal MediConnect plans transitioned to Medicare Medi-Cal plans (MMPs or Medi-Medi plans) provided by the same companies that provided Cal MediConnect plans.

Who funds Medi-Cal in California?

Medi‑Cal provides health care coverage to over 14 million Californians with low incomes. As a joint state‑federal program, costs are shared between the federal and state as well as local governments.

Is Blue Cross the same as Medi-Cal?

Medi-Cal Managed Care (Medi-Cal)

are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County.

How do I know what kind of Medi-Cal I have?

Contact your local county social services office to learn about your Medi-Cal status and eligibility. The California Department of Health Care Services has a full directory of each county's agency.

Can I go to any hospital with Medi-Cal?

Emergency Rooms: As stated above, if you have an emergency and you cannot find a doctor right away, you can go to the emergency room at any hospital. If you show your BIC to staff at the emergency room, Medi-Cal will pay for the services you receive.

Can California Medi-Cal be used out of state?

A: No. Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your Medicaid coverage when you're temporarily visiting another state, unless you need emergency health care.

What income does Medi-Cal use?

Income-based Medi-Cal counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based Medi-Cal eligibility.

Is Medi-Cal better than Medicaid?

Medi-Cal is what we call the joint Federal-State Medicaid program in California (just like Covered California is what we call Obamacare in California). Medi-Cal and Medicaid are essentially the same thing.

What changes to Medi-Cal 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. Medi-Cal managed care enrollment does ​​NOT affect a beneficiary's Medicare providers or Medicare Advantage plan.

Will I lose my Medi-Cal if I get a job?

If you get Medi-Cal coverage and then get a job, you have a couple of options for keeping your Medi-Cal benefits. If you got Supplemental Security Income (SSI) cash benefits before you got your job, Social Security's 1619(b) program lets you earn up to $56,758 annually and still keep Medi-Cal coverage at no cost.

Does Medi-Cal pay for everything?

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. Medi-Cal is California's part of a national health coverage program called Medicaid. Each state runs its own Medicaid program.

Is Medi-Cal only for low income?

Medicaid income eligibility in California is based on household size. To qualify for free Medi-Cal coverage, you need to earn less than 138% of the poverty level, based on the number of people who live in your home.

What type of insurance is Medi-Cal HMO or PPO?

Almost all Medi-Cal plans are “managed care plans” which means they function similar to an HMO. Medi-Cal Plans can be found in the Medi-Cal Managed Care Health Plan Directory. A managed care plan means you'll have a primary care physician, and they're the one person you'll see if you need medical care.

Can you have both Medi-Cal and Medicare?

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.

Does Medi-Cal cover more than Medicare?

Medi-Cal also provides additional benefits beyond what's usually included with Medicare Parts A and B, covering prescription drugs, dental, vision care, extended stays in skilled nursing facilities and long-term care in nursing homes.