Is Medi-Cal really free?

Asked by: Mabelle Tromp  |  Last update: December 24, 2023
Score: 4.1/5 (26 votes)

Medi-Cal offers free or low-cost health coverage for California residents who meet eligibility requirements. Most applicants who apply through Covered California and enroll in Medi-Cal will receive care through managed health plans.

How much is Medi-Cal monthly?

Medi-Cal monthly premium amounts have been reduced to $0.00 effective July 1, 2022. Monthly billing and collection of premiums for the Medi-Cal for Families program will no longer be required.

What is the downside of Medi-Cal?

There is a fundamental problem with Medi-Cal that is hindering patient access to care, and to specialists in particular – Medi-Cal physician reimbursement is so low that physicians cannot cover the cost of providing care.

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.

How much does Medi-Cal cost California?

For most families, Medi-Cal coverage for kids is free, with no premium, deductible or copays. For CCHIP coverage and sometimes for Medi-Cal, there is a fee of $13 per month per child, up to $39 per family. Want to get started with Covered California?

What Is Medi-Cal? (Part 1)

19 related questions found

Is Medi-Cal full coverage?

Medi-Cal covers most medically necessary care. This includes doctor and dentist appointments, prescription drugs, vision care, family planning, mental health care, and drug or alcohol treatment. Medi-Cal also covers transportation to these services. Read more in “Covered Benefits” on page 12.

How much do you have to make to qualify for Medi-Cal in California?

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.

Is Medi-Cal income based?

In some cases, you might be eligible for Medi-Cal based on your income alone, even if you're not signed up for another assistance program. Medicaid income eligibility in California is based on household size.

Does Medi-Cal pay Medi-Cal bills?

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.

Where does Medi-Cal money come from?

For every dollar that the state expends on allowable Medicaid costs, the federal government matches those funds at the applicable FMAP. The state share of Medi-Cal funding is drawn from multiple sources, including the state General Fund (GF), local matching funds, provider fees, and health plan taxes.

Does Medi-Cal check your assets?

4. How to Qualify. To find out if you qualify for one of Medi-Cal's programs, look at your countable asset levels. As of July 1, 2022, you may have up to $130,000 in assets as an individual, up to $195,000 in assets as a couple, and an additional $65,000 for each family member.

What are the pros of Medi-Cal?

What You Get
  • Preventive Care. Enjoy free services, like well-baby visits and checkups.
  • Emergency Services. Ambulance and emergency room services.
  • Primary Care. Doctor visits for sickness, injuries or other concerns.
  • Dental and Vision. ...
  • Family Planning. ...
  • Prescription Coverage. ...
  • Mental Health and Substance Use Disorder.

How long does Medi-Cal coverage last?

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?

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.

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 far back does Medi-Cal pay?

How long before applying for Medi-Cal can a person transfer assets? The Medi-Cal "Look-Back" period in California is 30 months.

What type of insurance is Medi-Cal considered?

Medi-Cal, California's Medicaid program, is a public insurance health care program which provides health care services for low-income individuals and families who meet defined eligibility requirements.

Does Medi-Cal report to IRS?

DHCS will only report a person's coverage to the IRS and FTB if that person receives coverage from Medi-Cal. Every person in the home enrolled in Medi-Cal will get their own Form 1095-B. If you have family members enrolled in Covered California, they should receive Form 1095-A.

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.

Does Medi-Cal affect taxes?

Does Medi-Cal count as minimum essential coverage (MEC)? Yes. Most people with Medi-Cal have coverage that counts as MEC and they will not face a tax penalty. However, there are individuals who have limited Medi-Cal coverage that does not meet MEC.

Are college students eligible for Medi-Cal?

Students can opt out of their student health plans and purchase coverage through Covered California. Depending on income, students may receive tax credits to help pay for a private health plan through Covered California or receive low- or no-cost coverage through Medi-Cal.

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.