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.

2. Do I get to keep my Medicare card?

Yes! You still use Medicare, but Medi-Cal helps pay your share of costs.

3. Can I still choose a Medicare Advantage plan?

Yes — and many D-SNP (Dual Special Needs Plans) are designed for people with both Medicare and Medi-Cal. These often include:

• $0 premiums
• Dental, vision, OTC cards, transportation
• Care coordination

4. Do I need to renew Medi-Cal each year?

Yes, Medi-Cal requires an annual redetermination. We help clients stay compliant so they don’t lose their benefits.

 Don’t Miss Out on Benefits You Deserve

We meet so many clients who:

• Didn’t know they were eligible
• Were paying hundreds per month unnecessarily
• Missed out on free dental, rides to appointments, or OTC allowances

Don’t let that happen to you.

 Get Help Applying for Medi-Cal + Choosing the Right Plan

At Peace & Grace Insurance Services, we:

• Help you check Medi-Cal eligibility
• Submit applications and renewals
• Match you with a dual plan that fits your care needs

 Call/Text: 209-812-4026  Email: CSinsurepng@icloud.com  Proudly serving all counties in California.