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.
