What are the big changes coming to Medi-Cal?
Asked by: Forrest Hansen | Last update: April 21, 2025Score: 4.2/5 (41 votes)
What is changing with Medi-Cal in 2024?
Medi-Cal health plans will have new rules starting in 2024. They are to advance health equity, quality, access, accountability, and transparency. As part of this, some Medi-Cal health plans will change on January 1, 2024. The change to a new Medi-Cal health plan does not affect your Medi-Cal eligibility or benefits.
What is the new law for Medi-Cal?
Starting January 1, 2024, a new law in California will give full Medi-Cal to more people ages 26 through 49 who qualify for Medi-Cal. Unlike before, immigration status does not matter.
What's going on with Medi-Cal?
Medi-Cal resumed its normal renewal processes on April 1, 2023. From that start date, it has 14 months to redetermine eligibility for around 15 million current enrollees. It's estimated that during this “unwinding period,” two to three million Californians may leave the program.
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.
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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.
What is the new name for Medi-Cal?
California Advancing and Innovating Medi-Cal (CalAIM) is a far-reaching, multiyear plan to transform California's Medi-Cal program and to make it integrate more seamlessly with other social services.
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.
How long can you keep Medi-Cal?
Medi-Cal members must renew their coverage each year to keep their health care benefits.
What is the new Medi-Cal law in California 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.
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.
Does Medi-Cal check your income?
Most people who apply for Medi-Cal can find out if they qualify based on their income. For some types of Medi-Cal, people may also need to give information about their assets and property.
What happens to my Medi-Cal when I turn 65?
If you are aged (65+) or disabled and are not eligible for the SSI program, you may be able to get Medi-Cal through the Aged & Disabled Federal Poverty Level (A&D FPL) program. To qualify, you must: Be aged (65+) or disabled (meet Social Security's definition of disability, even if your disability is blindness).
What are the proposed changes to Medicare in 2024?
Elimination of the five percent coinsurance for Part D catastrophic coverage. As of January 1, 2024, people with Medicare Part D are no longer responsible for five percent prescription cost-sharing in the 'catastrophic phase' of coverage.
Can you go to Kaiser if you have Medi-Cal?
Yes, if you meet the requirements for our Medicare Medi-Cal health plan, you also meet the requirements to enroll in a Kaiser Permanente Medicare health plan in the same service area.
How much can you make before you lose Medi-Cal?
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.
Do most doctors 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.
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 changes are coming to Medi-Cal?
You May Be Getting a New Health Plan
In 2024, Medi-Cal health plans must meet new requirements for quality, access, accountability, and transparency. This will improve our health plans statewide. Some Medi-Cal members in 21 counties may need to change to a new health plan on January 1, 2024.
What are the two types of Medi-Cal?
Medi-Cal is health coverage for low-income children and adults. There are two kinds of Medi-Cal, the expanded Modified Adjusted Gross Income (MAGI) coverage and classic coverage. Some Medi-Cal programs have a Share of Cost, but most do not.
What is the best Medi-Cal health plan in California?
Kaiser Permanente is also the only Medicare health plan in California to receive a 5-star rating, according to the Centers for Medicare & Medicaid Services' 2023 Medicare Star Ratings.
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 do some doctors not accept Medi-Cal?
Why doctors say they don't see Medi-Cal patients. While low reimbursement rates are the most common reason California doctors say they limit the number of Medi-Cal patients they see, the program's administrative burden is also daunting. Source: California Health Care Foundation.
Who is eligible for Medi-Cal in 2024?
Californians under 26 years of age, or over 50 years of age, are already eligible for full Medi-Cal. You do not need to fill out a new application for full Medi-Cal. You will automatically be enrolled into full Medi-Cal on January 1, 2024.