What Happens When You Qualify for Medi-Cal as a Medicare Recipient?

If you're on Medicare and have a limited income or resources, you may also qualify for Medi-Cal — California’s version of Medicaid. This opens the door to major savings and extra benefits many seniors don’t realize they're entitled to. Let’s break down how Medi-Cal + Medicare (also called “dual eligibility”) works, and why it can be a financial lifesaver.

What Is Dual Eligibility?

Dual-eligible individuals have both Medicare and Medi-Cal. This combo helps cover:

Medical services
Prescription drugs
Long-term care
Dental, vision, transportation, and more

Medi-Cal essentially acts as a “Medicare wraparound,” paying many of the costs that Medicare doesn’t cover.

What Does Medi-Cal Cover for Medicare Recipients?

ServiceCovered by MedicareCovered by Medi-Cal

Doctor Visits	Yes (partial)	Covers copays/deductibles
Hospital Stays	Yes	Covers deductibles
Prescription Drugs	Yes (Part D)	May cover premiums, co-pays
Dental/Vision	Limited	Often covered
Transportation	No	Often covered
Long-Term Care	Limited	Covered (if eligible)

Key Financial Benefits

1. No More Part B Premium

If you qualify for full-scope Medi-Cal, the state may pay your $185/month Part B premium(2025 rate).

2. No Copays or Deductibles

You may pay $0 out-of-pocket for most Medicare-covered services.

3. Extra Help with Prescriptions

Most dual-eligibles are auto-enrolled in “Extra Help” — a federal program that lowers drug costs dramatically:

$0 to $4.50 copays
No Part D premium
No coverage gap

FAQs: Medi-Cal and Medicare

1. How do I know if I qualify for Medi-Cal?

It depends on your income and assets. For 2025, individuals earning under $1,677/month(approx.) may qualify. Apply through BenefitsCal.com or talk to a licensed agent for help.