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Interactive tool
See if you may qualify for both Medicare and Medi-Cal.
See if you may qualify for both Medicare and Medi-Cal.
Some people are entitled to both Medicare and Medi-Cal and never find out. This tool is a quick look at whether you are one of them.
Medicare stays your primary coverage. It pays its share of hospital stays, doctor visits, and covered drugs.
Medi-Cal can pick up cost sharing that Medicare leaves behind. It also covers care Medicare does not, such as long stays in a nursing home.
A Dual Eligible Special Needs Plan coordinates the two programs, with one member card and one care team.
Some people qualify for full Medi-Cal. Others qualify with a share of cost, meaning they pay a set amount in a month before Medi-Cal starts paying. A Medicare Savings Program is a narrower form of help that covers Medicare premiums. The screening is the same conversation, so ask about all three.
There is a catch worth naming. A dual eligible plan is still an Advantage plan, so it uses a network. If your doctors are not in that network, the coordination may not be worth the switch. Check the names before you sign, not after.
Bring proof that you can act for them. That usually means a signed authorization, a power of attorney, or being listed as their representative with the county. Without it, agencies cannot discuss the file with you at all. Sorting that out first can save weeks.
Not sure is the most common answer
Eligibility turns on income, resources, household size, and sometimes a disability finding. None of that is obvious from the outside. If you answered not sure, treat that as a reason to apply rather than a no.
Have your Medicare card, income papers, and a drug list ready for a licensed agent. Plan availability and benefits vary by plan and area, and they can change. Verify the eligibility rules at medicare.gov or call 1-800-MEDICARE.
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