What are the benefits of Medi-Cal for seniors?

Asked by: Jaquan Wunsch  |  Last update: October 29, 2023
Score: 4.6/5 (17 votes)

Medi- Cal provides many of the state's poorest seniors with vital health insurance coverage, including wrap- around coverage for medical services Medicare does not cover. It also provides a safety net for seniors re- quiring long-term care who have exhausted their own financial resources.

Who is eligible for Medi-Cal seniors?

​​Basic Information​​ Beginning May 1, 2022, a new law in California will give full scope Medi-Cal to adults 50 years of age or older and immigration status does not matter. All other Medi-Cal eligibility rules, including income limits, will still apply.

Does Medi-Cal cover seniors?

Medi-Cal is a government program that pays for health and medical care for seniors 65 and over or disabled persons who have low incomes and limited resources.

Does Medi-Cal count Social Security benefits?

Unearned Income

This type of income relates to interest on savings and retirement accounts, pensions, annuities, veteran's benefits, etc. Social Security counts as unearned income as well. Gifts, royalties, and inheritances also count as unearned income.

What does Medi-Cal for adults include?

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.

What Is Medi-Cal? (Part 1)

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Is Medi-Cal based on income or assets?

To qualify, you must: Meet the medical requirements of Social Security's definition of disability. Be working and earning income (this can be part-time work). Have assets less than $130,000 for an individual and $195,000 for a couple.

Can I have both Medicare and Medi-Cal?

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.

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.

How much money can you have in the bank to qualify for Medicare?

On July 1st, 2022 the asset test to qualify for a Medicare Savings Program increased. These changes apply to the things you own, including bank accounts, cash, second homes and vehicles, and other financial resources. The new limit is $130,000 for one person and an additional $65,000 for each additional family member.

What age does Medi-Cal stop?

All California residents under the age of 26 who meet the eligibility requirements can qualify to receive Medi-Cal, regardless of U.S. citizenship or immigration status.

Can you get Medi-Cal after age 65?

You can also get Medi-Cal if you are:

65 or older. Blind. Disabled. Under 21.

What does Medi-Cal cover for adults in California?

​​​​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.

What determines Medi-Cal eligibility?

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.

Does Medicare cover 100% of a senior's eligible Medi-Cal expenses?

Medicare is a federally funded insurance program for eligible participants 65 or over. Medicare does not cover 100% of all costs and you may wish to purchase other Medicare-related insurance products such as Medicare Advantage or a Medicare Supplement policy.

Why am I eligible for Medi-Cal?

If your family has income at or below 138% of the Federal Poverty Level (FPL) (266% of FPL if you're a child), you may be eligible for Income-Based Medi-Cal. If you qualify for SSI (Supplemental Security Income), you are automatically eligible for SSI-Linked Medi-Cal.

What is the out of pocket maximum for 2023 Medi-Cal?

For the 2023 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $9,100 for an individual and $18,200 for a family. For the 2022 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $8,700 for an individual and $17,400 for a family.

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 renew every year?

Local Medi-Cal offices review each member's eligibility once a year or when they report changes to their household. Everyone's renewal date is different.

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.

What is the highest income to qualify for Medicaid 2023?

Parents of Dependent Children: Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

Is Medi-Cal free?

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 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.

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.