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 

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. 

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. 

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. 

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 

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. 

You can request a free consultation through our website or schedule a phone or virtual appointment at a time that is convenient for you.