Understanding Your Medicare & Medi-Cal Options
Some people qualify for both Medicare and Medi-Cal and are called “dual-eligible” or Medi-Medi beneficiaries. It is important for you to know the differences between Medicare and Medi-Cal, and how Medicare works with Medi-Cal, and who is responsible for paying your medical bills.
It is also important for you to know and understand your options for receiving your Medicare coverage, and, how Medi-Cal works with Medicare for each of the options.
When you have Medicare Parts A and B, Medicare is your primary insurance and pays for most of your medical care. Medi-Cal is your secondary insurance. It pays for costs not covered by Medicare and provides additional benefits not covered by Medicare.
What is Medicare?
Medicare is health insurance for:
You have Medicare if you have this card:
Medicare consists of 4 parts:
Medicare beneficiaries can choose how to receive their Medicare benefits and services:
What is Medi-Cal?
Medicaid, called Medi-Cal in California, is a joint federal and state program that helps pay medical costs for people with limited income and/or resources (assets). Some people qualify for both Medicare and Medi-Cal.
You have Medi-Cal if you have either of these cards:
Current Medi-Cal Cards
Older Medi-Cal Card, still accepted
What does Medi-Cal cover?
How do I qualify?
Your income and resource levels must meet the state eligibility requirements.
Where do I enroll?
Who administers Medi-Cal?
What is Medi-Cal with Share of Cost?
How can I eliminate or meet my share of cost?
What Coverage Options are available for Medi-Medis?
Option 1: Original Medicare
Option 2: Medicare Advantage Plans (MA) (Medicare Part C)
Are there plans just for people with Medicare and Medi-Cal?
Yes. The Dual Eligible Special Needs Plan (D-SNP) is for people covered by both Medicare and Medi-Cal. These individuals are also referred to as dual-eligible or Medi-Medi. D-SNPs provide Medicare and Medi-Cal benefits, including specialized care and wrap-around services for their plan members.
In Orange County, one D-SNP, OneCare, is referred to as a Medi-Medi Plan. This plan, offered by CalOptima Health, combines your Medicare and Medi-Cal benefits into one plan and coordinates care across all your healthcare needs.
Your Rights & Protections
We Can Help
Call HICAP for additional information or counseling services
HICAP Statewide (800) 434-0222
Orange County (714) 560-0424
Health Insurance Counseling & Advocacy Program
Services also available in Spanish, Vietnamese, Korean, Chinese and Farsi
HICAP does not sell or endorse any insurance products
This project was supported, in part by grant number 90SAPG0094-04-00, from the U.S. Administration for Community Living (ACL), Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.
This project is supported by the California Department of Aging and Orange County Board of Supervisors.