What is the difference between Medicare and Medi-Cal California?
Asked by: Brielle Goodwin | Last update: November 25, 2025Score: 4.6/5 (3 votes)
Can you have both Medicare and Medi-Cal?
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."“
Does everyone over 65 qualify for Medi-Cal in California?
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 is the maximum income to 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. You can qualify for Medi-Cal even if you have assets.
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.
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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 is Medi-Cal different from Medicare?
Medi-Cal is California's Medicaid health care program. Medi-Cal pays for a variety of medical services for children and adults with limited income and resources. Medicare is a federally funded insurance program for eligible participants 65 or over.
How much money can I have in my bank account if I 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. Starting on January 1, 2024, Medi-Cal applications will no longer ask for asset information. » I was not eligible in the past.
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.
Will I lose my Medicaid if I get Medicare?
People who have both Medicare and full Medicaid coverage are “dually eligible.” Medicare pays first when you're a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have.
Does social security count as income for Medi-Cal?
Income-based Medi-Cal counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts.
At what age does Medi-Cal stop?
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.
Do seniors get free healthcare in California?
Yes. Medi-Cal offers free or low-cost health care for people who live in California. Full scope Medi-Cal is different from the restricted scope Medi-Cal coverage you have now. Restricted scope Medi-Cal only covers some services, but it does not cover things like medications and primary care.
What is the 3 month rule for Medi-Cal?
You may be able to receive a reimbursement if:
You received a Medi-Cal covered service on a date that you were eligible for Medi-Cal. The three periods of eligibility that are included are the following: RETRO: The 3-month period prior to the month you applied for the Medi-Cal program.
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.
How does Medi-Cal verify income?
Earned Income Most recent pay stub, written statement from employer, completed employer's income verification letter. All verification must show gross income, pay period, date received and hours worked.
What are the new rules for Medi-Cal in 2024?
On January 1, 2024, Medi-Cal eliminated any asset limit for enrollees and instead considers only applicants' income when assessing financial eligibility for benefits.
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 taxes?
The Modified Adjusted Gross Income (MAGI) Medi-Cal method uses Federal tax rules to decide if you qualify based on how you file your taxes and your countable income.
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.
Does having a savings account affect Medi-Cal?
Starting January 1, 2024, assets will no longer be counted to determine Medi-Cal eligibility!
Do you qualify for Medi-Cal if you are over 65?
For adults age 65 or older, the income limit for no-cost Medi-Cal is only 122% of the poverty line. Once they turn 65, many Californians with low incomes cannot access free Medi-Cal because the countable income limit for seniors, which is set by the state, is much lower than it is for younger adults.
Which is the cheapest health insurance for senior citizens?
Medicare is the cheapest health insurance with the best benefits for people age 65 and older or who have a qualifying disability.
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 if my income is too high for Medi-Cal?
Yes. If you make too much to qualify for Medi-Cal, you can apply for Covered California. Covered California is a state-run health care insurance exchange that offers financial assistance to reduce your premiums payments.