Why do some doctors not accept Medi-Cal?
Asked by: Raquel Kiehn | Last update: October 25, 2025Score: 4.8/5 (68 votes)
Why don't doctors accept Medi-Cal?
The most frequent reasons physicians limit Medi-Cal patients in their practices are payment rates and administrative hassles. Not surprisingly, the report concludes that raising physician reimbursement rates and making more timely payments to physicians may increase physician participation.
Why would someone not qualify for Medi-Cal?
To qualify, you must: Meet the medical requirements of Social Security's definition of disability. Be working and earning income (this can be part-time work). Have countable income less than 250% of the federal poverty level (in 2024, this equates to $3,158/mo.
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.
Can you go to any doctor with Medi-Cal?
Once you are enrolled in a Medi-Cal health plan, you need to choose a primary care doctor who works with your Medi-Cal health plan. You can ask your current doctor if they work with a Medi-Cal health plan in your county.
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What are the restrictions for Medi-Cal?
If you apply for Medi-Cal in 2023:
The current asset limit is $130,000 for one person. Each additional household member adds $65,000 to the asset limit. Up to 10 members can be in a household. Medi-Cal will also consider income information (including income from property).
How to make a doctor's appointment with Medi-Cal?
You can book appointments through the app, on the website or with a call to 1-800-TELADOC (835-2362). Medical appointments can occur 24/7 from any place.
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.
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 is 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 disqualifies someone 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.
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.
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.
Why was I denied Medi-Cal?
Eligibility Issues: Denials can occur due to discrepancies in income, residency, or documentation, leading to questions about eligibility. Prior Authorization: Some treatments require prior authorization, and failure to obtain this or administrative errors can lead to denials.
What percentage of doctors accept Medi-Cal?
From 2013 to 2015 the percentage of California physicians serving Medi-Cal patients decreased from 69% to 64%, but the over- all number of full-time equivalent (FTE) physicians serving Medi-Cal patients increased by 9% (not shown, see page 11).
Why do so few doctors accept Medicaid?
One reason is that reimbursement rates for Medicaid are lower than for Medicare or commercial insurance. Another (often overlooked) factor, however, is physician's risk of payment denials and the administrative hassle they face trying to get reimbursed by Medicaid.
Why does no one accept Medi-Cal?
The reason for this lack of access, according to UC administrators, is because state reimbursements for Medi-Cal patients don't cover the cost of treating them. It's even worse for Medi-Cal patients seeking medical specialists, such as neurologists, orthopedic surgeons and cardiologists.
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?
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.
Can I own a home and get Medi-Cal?
Yes, you can. First, your primary residence is an “exempt asset” for purpose of the Medi-Cal eligibility process, meaning your primary residence is not counted as a resource for Medi-Cal qualification because it is an exempt asset.
How much does Covered California cost per month?
Apply for health insurance by Jan. 31 — and pay as little as $10 per month if you qualify. How many need coverage? Your Estimate $63 per month for a Silver plan. Bronze as low as $0.
Can you go to any doctor if you have Medi-Cal?
Before you get medical or dental services, ask if the provider accepts Medi-Cal Fee-for-Service payments. The provider has a right to refuse to take Medi-Cal patients. If you do not tell the provider you have Medi-Cal, you may have to pay for the medical or dental service yourself.
What is the fastest way to get Medi-Cal?
These are the fastest ways to find out if you are eligible for ongoing full-scope Medi-Cal: Search for in-person help near you for someone who can help you complete your application. Apply online on http://www.benefitscal.com or CoveredCA.com. Call or visit a Medi-Cal office in your county.
What is the income limit for Medi-Cal 2024?
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.