What does Medi-Cal for adults include?
Asked by: Prof. Elijah Jones PhD | Last update: August 14, 2025Score: 5/5 (67 votes)
What does Medi-Cal cover for adults?
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 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.)
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 You NEED TO KNOW About New Medi-Cal Eligibility Rules
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 are not qualified Medi-Cal expenses?
Medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness. They don't include expenses that are merely beneficial to general health, such as vitamins or a vacation.
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.
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 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 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.
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 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.
Does Medi-Cal pay for glasses for adults?
Are eyeglasses covered under Medi-Cal? Medi-Cal does not cover eyeglasses for adults over the age of 21.
Does Medi-Cal cover teeth cleaning?
Medi-Cal covers all the basics including; dental exams (2x a year), teeth cleanings every 6 months, x-rays, tooth removals, emergency services, molar sealants, fillings, fluoride treatments and root canals.
What are the new rules for Medi-Cal 2024?
Basic Information. 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.
How often does Medicaid check your bank account?
Medicaid agencies can check your account balances for bank accounts at any financial institution you've used in the past five years. They will check when you submit an application and on an annual basis, but checks can occur at any time.
How do I check Medi-Cal eligibility?
Who is eligible? Qualify for Medi-Cal if your income is up to 138 percent of the Federal Poverty Level (FPL) for adults, and up to 266 percent FPL for children. Check Shop and Compare to see if you qualify. Learn more on the Department of Health Care Services website.
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.
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.
Can I have both Medi-Cal and Medicare?
Can a person have both Medicare and Medi-Cal? Yes. Sometimes that's callled “Medi-Medi”, or “dual eligible.” Medicare is billed first for services and Medi-Cal is billed last. Medical providers are famliar with “Medi-Medis."“
What income disqualifies you from Medi-Cal?
You must financially qualify 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.
Can you claim Medi-Cal bills on your taxes?
Key Takeaways
The IRS allows all taxpayers to deduct their qualified unreimbursed medical care expenses that exceed 7.5% of their adjusted gross income. You must itemize your deductions on IRS Schedule A in order to deduct your medical expenses instead of taking the Standard Deduction.
What are non-qualified expenses?
They include fees for tuition, facilities, technology, mandatory fees, and a portion of the course and services fees. Nonqualified expenses are defined as room and board, student activities, parking, athletics, insurance, equipment, or other similar personal living expenses.