Frequently Asked Questions
Medi-Cal / Medicaid
What is Medi-Cal?
Medi-Cal is California’s Medicaid program that helps individuals with limited income pay for healthcare services such as doctor visits, hospital care, and prescription medications.
Who qualifies for Medi-Cal?
Eligibility is based primarily on income and household size. Many seniors, individuals with disabilities, and low-income families may qualify. Some people who receive Medicare may also qualify for Medi-Cal to help cover additional healthcare costs.
Can I have both Medicare and Medi-Cal?
Yes. Many people qualify for both programs. This is called being “dual eligible.”
When someone has both:
Medicare pays first
Medi-Cal helps pay remaining costs such as premiums, copays, and coinsurance.
Does Medi-Cal pay my Medicare premium?
In many cases, yes. Programs like QMB (Qualified Medicare Beneficiary) may allow Medi-Cal to pay:
Your Medicare Part B premium
Copays
Coinsurance
Deductibles
Medicare
What is Medicare?
Medicare is a federal health insurance program primarily for individuals age 65 and older or those with certain disabilities.
Medicare has four parts:
Part A — Hospital Insurance Hospital stays, skilled nursing care, hospice, and some home health services.
Part B — Medical Insurance Doctor visits, outpatient care, lab work, preventive services, and medical equipment.
Part C — Medicare Advantage Private insurance plans that combine Part A and Part B.
Part D — Prescription Drug Coverage Helps pay for prescription medications.
When should I apply for Medicare?
Most people should enroll during their Initial Enrollment Period, which is:
3 months before your 65th birthday
The month of your birthday
3 months after your birthday
Delaying enrollment could result in lifetime penalties.
How much does Medicare cost?
Costs vary depending on your coverage and eligibility. For many people:
Part A: Usually $0 if you worked at least 40 quarters
Part B: Monthly premium set annually by Medicare
Additional coverage: May vary depending on the plan you choose
Some individuals may qualify for Extra Help or Medi-Cal, which can significantly reduce costs.
Medicare Advantage
What is a Medicare Advantage Plan?
A Medicare Advantage plan (Part C) is offered by private insurance companies approved by Medicare.
These plans combine hospital and medical coverage and often include additional benefits such as:
Prescription drug coverage
Dental care
Vision services
Hearing aids
Fitness programs such as SilverSneakers
Transportation to medical appointments
Over-the-counter allowances
Many plans offer $0 monthly premiums, depending on eligibility and location.
Can I keep my doctor with a Medicare Advantage plan?
It depends on the plan network.
Some plans require members to choose doctors within a specific medical group or provider network.
Medicare Supplements (Medigap)
What is a Medicare Supplement plan?
A Medicare Supplement plan, also called Medigap, helps pay for healthcare costs that Original Medicare does not fully cover.
These plans may help pay for:
Deductibles
Copayments
Coinsurance
Do Medicare Supplement plans include prescription drugs?
No.
Most Medicare Supplement plans do not include prescription drug coverage, so a separate Medicare Part D drug plan is usually required.
Dual Special Needs Plans (D-SNP)
What is a D-SNP plan?
A Dual Special Needs Plan (D-SNP) is a type of Medicare Advantage plan designed for individuals who qualify for both Medicare and Medi-Cal.
These plans help coordinate benefits between the two programs.
What extra benefits do D-SNP plans often include?
Many D-SNP plans offer additional benefits such as:
Grocery or healthy food allowances
Over-the-counter (OTC) benefits
Transportation to medical appointments
Dental, vision, and hearing coverage
Care coordination services
Our Services
Do you charge for your services?
No.
Our consultations and assistance are completely free.
We help individuals:
Understand Medicare
Compare available plans
Check doctor networks
Review Medi-Cal eligibility
Enroll in a plan if it fits their needs
There is no cost and no obligation to speak with us.
How can i schedule a consultation?
You can request a free consultation through our website or schedule a phone or virtual appointment at a time that is convenient for you.