What are the pros of Medi-Cal?

Asked by: Dr. Matteo Berge  |  Last update: December 29, 2023
Score: 4.1/5 (48 votes)

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.

What are the benefits of having Medi-Cal?

​​​​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).

Is Medi-Cal a good program?

The health plans offered by Covered California and Medi-Cal include the same full set of benefits, but Medi-Cal is usually at lower or no cost. You can preview plans and benefits here. In a recent survey of Medi-Cal members, 90% of the members who answered rated Medi-Cal as a good or very good program.

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.

Is Medi-Cal really free?

For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. Effective July 1, 2022, all monthly premiums were reduced to $0.00.​ In general, individuals in Medi-Cal will get the same health benefits available through Covered California at a lower cost.

What Is Medi-Cal? (Part 1)

43 related questions found

Is Medi-Cal for poor families?

This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources.

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.

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.

How much income is too much for 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.

Does Medi-Cal cover emergency room visits?

In the event you have a medical emergency before you find a doctor, contact 9-1-1 or go to the emergency room at your nearest hospital. Medi-Cal does cover emergency services for enrolled members, and if you show your BIC to emergency room staff, Medi-Cal will pay for the services you receive.

Can I choose Covered California instead of Medi-Cal?

You may be eligible for health coverage through Covered California if you are no longer eligible for Medi-Cal due to an income increase or change in household size. In order to avoid a gap in your health coverage, Covered California can help you select a new plan before your Medi-Cal coverage ends.

What age is Medi-Cal for?

You can also get Medi-Cal if you are:

65 or older. Blind. Disabled. Under 21.

Does Medi-Cal check savings?

Tese rules will continue under the asset limit increase in July 2022. After January 2024, the ownership of a home, more than one vehicle, or the amount of money and savings in a banking account, will not be taken into account for Medi-Cal benefts. Q: Will Medi-Cal income limits change?

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 does it mean to be on 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 reported on taxes?

Yes, DHCS is responsible for reporting any month(s) of Medi-Cal coverage that meets the requirement for MEC to the IRS and Franchise Tax Board (FTB). DHCS must also provide a Form 1095-B to all people whose coverage was reported to the IRS and FTB. The form you will get will show which months you had MEC.

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.

Does California Medi-Cal cover dental implants?

Medi – Cal generally does not cover implants.

However, check out Dental for Everyone they have plans that will cover implants! Remember though, there is no free lunch. Insurance Companies have to take in more money in premiums than the pay in claims…

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?

Does Medi-Cal pay for housing?

However, under Medi-Cal, Managed Care Plans are responsible for providing non-emergency transportation to medical services. What Housing Services Are Provided? The HHP provides services to help patients obtain and maintain housing. It does not provide actual housing for patients.

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.

What are the different types of Medi-Cal?

​​​Find Out More About Medi-Cal Programs​​​
  • Medi-Cal Dental Program. Dental services are currently provided as one of the many benefits under the Medi-Cal program.
  • Fair Hearing. ...
  • Health Insurance Premium Payments. ...
  • Medi-Cal. ...
  • Medi-Cal Eligibility. ...
  • Medi-Cal Estate Recovery. ...
  • Medi-Cal Managed Care.