Medi-Cal, the Medicaid program in California, provides health coverage to people with low-income and asset levels who meet certain eligibility requirements. Medi-Cal can supplement Medicare services and help pay Medicare premiums, deductibles and copayments. In certain cases, Medi-Cal may also be used to pay private health insurance premiums. Medicare Part D (prescription drug coverage) has special rules and provides financial help for people with both Medicare and Medi-Cal. For more information, see our Extra Help with Part D Costs for People with Low Income and Medi-Cal sections.
If you are blind or have a disability and receive Supplemental Security Income (SSI), you are automatically eligible for Medi-Cal. To qualify for SSI, your monthly income and assets cannot exceed certain limits. Note: Many people with disabilities who qualify for SSI (including most children), are not eligible for Medicare benefits because they do not have the work credits to qualify for Social Security Disability Insurance (SSDI) benefits. These people are only covered by Medi-Cal, not Medicare.
When medical benefits are covered by both Medicare and Medi-Cal, Medicare is the primary payer and Medi-Cal is the secondary payer. When services such as dental care or long-term care are covered only by Medi-Cal, it is the sole payer. If you have both Medicare and Medi-Cal, be sure the medical providers you choose accept both sources of payment for your care. Otherwise, you may face billing delays or be required to pay unexpected medical costs.
In general, it is easier for people with disabilities to find medical providers who will accept them as patients if they have both Medicare and Medi-Cal coverage, as opposed to Medi-Cal alone.
Other Ways to Qualify for Medi-Cal
You can qualify for Medi-Cal in several ways besides SSI eligibility. We’ve listed some of the most common ways below. We’ve also included information about a program that helps Medicare beneficiaries with high-cost medical conditions pay private insurance premiums.