Is there a deductible for Medi-Cal?

Asked by: Aditya Rippin  |  Last update: December 21, 2025
Score: 4.2/5 (24 votes)

The share of cost is like a private insurance plan's monthly deductible. You only pay if you get medical care. You only need to pay for healthcare costs up to the amount of your share of cost. Once you have met your share of cost, we will pay for the rest of your services in that month that are covered by Medi-Cal.

What expenses are deductible for Medi-Cal?

Examples of Medi-Cal income deductions include: child or dependent care, work expenses, court-ordered child support, alimony, educa- tional expenses, and health insurance premiums for other family members. The kind of docu- mentation required for income deductions varies based on the type of deduction and the source.

Does Medi-Cal cover deductibles?

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 ...

Do I have to pay anything with Medi-Cal?

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. You can reach your local county office online at www.benefitscal.com.

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.

How does a health insurance Deductible work?

20 related questions found

What are the out of pocket expenses for Medi-Cal insurance?

Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren't covered.

What is the disadvantage of Medi-Cal?

The perception that Medi-Cal offered poorer coverage or less respectful treatment than other types of insurance. Concerns among noncitizen respondents that applying for Medi-Cal might affect their immigration status.

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.

Can you have both Medi-Cal and Covered California?

If you are eligible for Medi-Cal, you can still purchase a health coverage plan through Covered California, but you cannot receive premium assistance to reduce its cost and will have to pay the full cost of the Covered California health care plan's premium.

Does Medi-Cal have copays?

Individuals who qualify for Medi-Cal will have no or low monthly premiums, no copays, and no out-of-pocket costs for most covered services.

What is my Medi-Cal deductible?

The amount you pay for covered health care services before your insurance plan starts to pay.

What is the income limit for Medi-Cal 2024-2023?

For 2024, the income limits are generally expressed as a percentage of the FPL and vary by the individual's category. For example, an individual may qualify for Medi-Cal if their yearly income is at or below $20,783. A couple may qualify for Medi-Cal if their annual income is at or below $28,208.

Are Medi-Cal expenses 100% deductible?

How Much of the Expenses Can You Deduct? Generally, you can deduct on Schedule A (Form 1040) only the amount of your medical and dental expenses that is more than 7.5% of your AGI.

What income is not countable for Medi-Cal?

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.

Will Medi-Cal pay for past Medi-Cal bills?

Retroactive Medi-Cal covers unpaid medical expenses from the three months prior to the month you apply for Medi-Cal. If you have unpaid bills from the three previous months, enter that information during the application process. If you qualify for Medi-Cal, you will also be evaluated for retroactive coverage.

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.

What is the new law for Medi-Cal in 2024?

Beginning January 1, 2024, a new law in California will allow adults ages 26 through 49 to qualify for full-scope Medi-Cal, regardless of immigration status. All other Medi-Cal eligibility rules, including income limits, will still apply.

Can I have money in the bank and still get Medi-Cal?

➢ Do assets affect my eligibility? Starting on January 1, 2024, assets, such as bank accounts, cash, a second vehicle, and homes, will no longer be counted when determining Medi-Cal eligibility. Income and income from assets, such as income from property, will continue to be counted.

Why does no one accept Medi-Cal?

The most frequent reasons physicians limit Medi-Cal patients in their practices are payment rates and administrative hassles.

Is Medi-Cal as good as Covered California?

Covered California health plans require payment of premiums and other costs such as copays and coinsurance, while Medi-Cal can provide health coverage at low- to no-cost.

Do most doctors accept Medi-Cal?

Do All Doctors Have to Accept Medi-Cal? Not necessarily. Doctors can refuse to take Medi-Cal patients. Before receiving treatment, check whether the provider accepts Medi-Cal Fee-For-Service payments to avoid having to pay out of pocket.

Can I pay out-of-pocket if I have Medi-Cal?

There are also no co-payments or out-of-pocket costs associated with receiving benefits under MAGI Medi-Cal. Non-MAGI Medi-Cal: The amount that a family or an individual must pay for Medi-Cal benefits is determined by the amount of available income that remains after appropriate exclusions and deductions are allowed.

What are typical itemized deductions?

Itemized deductions, subject to certain dollar limitations, include amounts you paid, during the taxable year, for state and local income or sales taxes, real property taxes, personal property taxes, mortgage interest, disaster losses, gifts to charities, and medical and dental expenses.

What is the maximum out-of-pocket?

What is an Out-of-Pocket Maximum and How Does it Work? An out-of-pocket maximum is a cap, or limit, on the amount of money you have to pay for covered health care services in a plan year. If you meet that limit, your health plan will pay 100% of all covered health care costs for the rest of the plan year.