What does Medi Cal cover?
Asked by: Dexter Champlin | Last update: June 17, 2025Score: 4.8/5 (60 votes)
What exactly does Medi-Cal cover?
Medi-Cal covers primary care, specialty care, prescription drugs, and dental if it is considered "medically necessary." Most people who have Medi-Cal do not pay co-pays or out-of-pocket costs.
What other benefits can I get with Medi-Cal?
- 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 are the cons 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.
What You NEED TO KNOW About New Medi-Cal Eligibility Rules
How much money can you have in the bank if you have Medi-Cal?
For new Medi-Cal applications only, current asset limits are $130,000 for one person and $65,000 for each additional household member, up to 10.
Why don t doctors 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.
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.
Is Medi-Cal really free?
Medi-Cal offers free or low-cost health coverage for Californians who meet eligibility requirements, regardless of immigration status. Most applicants who apply and enroll in Medi-Cal will receive care through Medi-Cal health plans.
What does Medicaid not cover?
Though Medicaid covers a wide range of services, there are limitations on certain types of care, such as infertility treatments, elective abortions, and some types of alternative medicine. For example, the federal government lists family planning as a mandatory service benefit, but states interpret this differently.
Do you 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.
Does Medi-Cal dental cover implants?
Currently, Medi-Cal covers implants only when “exceptional medical conditions are documented,” according to the state's 2024 benefits guide.
Does Medi-Cal cover an ambulance?
Medi-Cal covers ambulance and non-emergency medical transportation (NEMT) only when ordinary public or private conveyance is medically contra-indicated and transportation is required for obtaining needed medical care. Non-medical transportation (NMT) is used for a recipient to obtain covered Medi-Cal services.
What are full benefits under Medi-Cal?
Prescription Drugs
Physician services • Hospital outpatient & outpatient clinic services • Outpatient surgery (includes anesthesiologist services.) Podiatry • Chiropractic • Allergy care • Treatment therapies (chemotherapy, radiation therapy, etc.)
Does Medi-Cal cover hospital 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. Medi-Cal is California's part of a national health coverage program called Medicaid.
How much is Medi-Cal a month?
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 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 counts as expenses for Medi-Cal?
Some examples include: purchase of medical equipment, • purchase of prescription drugs, • payment for medical services (including dental, mental health, and other services).
What's the cheapest health insurance in California?
Affordable health insurance in California for 2025
L.A. Care has the cheapest rates in California, and it's the cheapest health insurance company for about a quarter of the people in California. But you can only get L.A. Care if you live in Los Angeles County.
Does Medi-Cal check bank accounts?
➢ 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.
Do I have to pay back Medi-Cal?
The Medi-Cal program must seek repayment from the estates of certain deceased Medi-Cal beneficiaries. Repayment only applies to benefits received by these beneficiaries on or after their 55th birthday and those who owned assets at the time of death.
Who is not eligible for Covered California?
Who is Not Eligible for Covered California? If you are not lawfully present in California, you are not eligible for a Covered California plan. However, you can still apply through Covered California to find out if you are eligible for Medi-Cal or to find coverage for family members who are lawfully present.
Can I go to any ER with Medi-Cal?
Emergency Rooms: As stated above, if you have an emergency and you cannot find a doctor right away, you can go to the emergency room at any hospital. If you show your BIC to staff at the emergency room, Medi-Cal will pay for the services you receive.
Is Medi-Cal as good as Covered California?
Medi-Cal provides benefits similar to the coverage options available through Covered California, but often at lower or no cost to you or your family. All of the health plans offered through Covered California or by Medi-Cal include the same comprehensive set of benefits known as "essential health benefits.”
How long does Medi-Cal last?
If you do still qualify, the letter will indicate that your Medi-Cal is renewed for one year. If you do not still qualify, the letter will indicate when the your Medi-Cal coverage ends.