Online Enrollment & Quotes for Cal Medi Connect
Online Enrollment & Quotes for Medi Medi MAPD Plans

20 Minute Video Explanation 

Los Angeles County Medical Assoc Video 1 hour 48 minutes

Cal Medi Connect Los Angeles
Cal Medi Connect Los Angeles – Including Bookmarks
Cedars Sinai
Cedars Sinai – Plan Section Tool & Info
getting-keeping-coverage
Non MAGI Medi-Cal

Cal Medi Connect program

Medi Medi – Medi care & Medi-Cal   (MMP – Dual Eligible)

Must choose a Medicare Advantage Plan & Medi-Cal HMO or one will be chosen for them?

Option A Medicare & Medi-Cal in ONE plan (Los Angeles Options)

Option B Keep Medicare  (Get an Advantage Plan)  and get a Medi-Cal Plan (Los AngelesCal Duals.org    Cedars Sinai

Consumer Links

Get FREE Quotes & Enroll in Medicare Advantage – Note we get a finders fee, but are NOT your agent.

Cal Duals.org  Los Angeles Guidebook, including bookmarks  Their email address  [email protected]

Our website on Medicare Advantage Plans

Cedars Sinai Tool & Information – How to OPT OUT!  Also applies EVEN if you don’t use their facilities!

Los Angeles CountyLA County Map

Cal MediConnect Health Plans:

These are special health plans that cover nearly all Medicare and Medi-Cal benefits plus vision care and non-emergency transportation benefits. This  means you can call one place for help with all of your health care needs.  In a Cal MediConnect plan, you keep all the benefits and services you get today,  but you must use doctors and providers who work with this health plan or are  “in the network.”

Get Quotes and Apply ONLINE for Cal Medi Connect Medicare Advantage Plans!   Please note, we get a finders fee if you use this tool, but are NOT your agent.

The telephone numbers below are for new members:

L.A. Care Cal MediConnect Plan

CareMore Cal MediConnect Plan

Care1st Cal MediConnect Plan

 Health Net Cal MediConnect

Molina Dual Options

Brand New Day

dhcs.ca.gov  Technical Page on Cal Medi-Connect Demonstration

Health Care Options  844.580.7272  – State Enrollment Broker – Enroll & Dis-enroll

HICAP   1-800-434-0222

See our Medi Cal Page

Medi-Cal Providers

Los Angeles Times 2.1.2015 Problems with shifting care for costly patients

DHCS.Gov Medi-Cal Managed Care

ca health advocates.org (Medi-Cal)

LIS – Low Income Subsidy
(Medicare Part D Rx – Help with Drug Costs)

Doctor’s can’t bill Medi Medi patients for Co Pays, Deductibles, etc.

InsureMeKevin.com   on Blue Cross SNP & Dual Eligibility with Medi-Cal

Fraud, Waste & Abuse

Justice in Aging  duals demo advocacy.org/

Categories of dual eligible beneficiaries
and out-of-pocket costs that must be paid by Medi-Cal – Medicaid:

Qualified Medicare Beneficiary  (QMB)

  • Medicare Part A and Part B premiums; ♦ cost sharing for Part A & Part B benefits.
  • QMB Plus – Medicare Part A and Part B premiums; cost sharing for Part A & Part B benefits; Full Medicaid benefits.
  • SLMB (only) (Specified Low-Income Medicare Beneficiary) – Medicare Part B premium.
  • SLMB Plus – Medicare Part B premium; Full Medicaid benefits.
  • QI (Qualifying Individual) – Medicare Part B premium.
  • Other FBDE (Full Benefit Dual Eligible) – Medicare Part B premium; Full Medicaid benefits.
  • QDWI (Qualified Disabled & Working Individual) – Part A premium. (AHIP Training  CA Health Advocates)

Learn More about Medicare Savings Programs (MSP’s)  ⇒  CA Health Advocates

medi helper.com  They can help you qualify… they do charge a fee based on the complexity of the case.   Free Intake – Assessment Form

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Other pages in Medicare Advantage Section

Additional Social Services – in addition to Medi-Cal

Medi-Cal Estate Recovery

Technical Links

SB 1008 and SB 1036

Dual Eligible Performance Studies – Inovalon

Needs assessment checklist

Problems with Medi-Medi – unwitting Guinea Pigs real clear policy.com

8 comments on “Medi Medi – Medi-Cal & Medicare, Together

  1. My 92 year old mother is on Medi-cal and Scan, but needs to go into assisted living with waiver application they won’t accept Scan said she has to drop it, does she automatically go on Medi–Medi and will her new doctor take it? The application takes 3-6 months for approval but I have to drop her from Scan insurance before I fax over the waiver form…Any suggestions are appreciated.

    ***See our new ALW – California Assisted Living Page.

  2. My disabled niece has misplaced her medi medi card and since she does not speak I am trying to help her out, where/how does she get it replaced?

  3. I am confused. We have aarp Medicare advantage Hmo plan and our Doctor recommended that we also have medi medi care card for assistance as we are deaf, disabled living on fixed social security incomes.Can you elaborate/explain and are we eligible for additional help?
    Brad & Dianna K. We are 77 and 75 in 2017.

  4. Hello.

    I am the social security payee for my mentally challenged adult son who lives in California. One of his papers I have says he qualifies for extra help, and is Medi Medi, without a share of cost.

    He is coming to visit me in Indiana for three months. During that time, his psychiatric medications will be mailed to me for him, so that’s not a problem.

    But what if he gets the flu or is injured, such as a broken arm, appendicitis, etc. Will doctors in Indiana be able to treat him?

    Thank you.

    • Assuming your son still has his Medicare Card, Parts A Hospital and B Doctors would pay anywhere in the USA. See “Medicare & You” Page 38 et seq for Part A Coverage and Page 43 for Part B.

      Outside of CA Medi-Cal (CA version of Medicaid) only pays for emergencies… Learn More DSS.Cahwnet.Gov Out-of-State Provider Unit at (916) 636-1960. Learn More Medi-Cal.ca.gov

      This page may help you find a provider that accepts Medicare, Medi-Cal & Medicaid. Just about every MD accepts Medicare.

      FAQ’s from Medi-Cal’s Website

      18. What is a temporary out-of-state provider?

      The Out-of-State Provider Unit may enroll certain out-of-state providers and allow payment for up to $599.99, or 10 paid claim lines per calendar year, before they are required to complete the standard enrollment forms. Once this billing limit is reached, the provider is informed through a system-generated letter that enrollment as a permanent provider in the Medi-Cal program is necessary prior to receiving further payment. The letter instructs the provider to bill Medi-Cal again for non-paid claims after the Department of Health Care Services (DHCS) has received and approved a provider’s enrollment. Providers unable to use the temporary enrollment format should complete the permanent provider enrollment forms available on the Medi-Cal website’s Provider Enrollment webpage. For questions about which forms to use, contact the Out-of-State Provider Unit at (916) 636-1960.

      14. What is Share of Cost (SOC)?

      Some Medi-Cal recipients must pay, or agree to pay, a monthly dollar amount toward their medical expenses before they qualify for Medi-Cal services. This dollar amount is called Share of Cost (SOC). A Medi-Cal recipient’s SOC is similar to a private insurance plan’s out-of-pocket deductible.

      Recipients are not eligible to receive Medi-Cal benefits until their monthly SOC dollar amount has been certified online. Certifying SOC means that a provider has verified that a recipient has paid or become obligated to pay the entire monthly dollar SOC amount owed. Claims submitted for services rendered to a recipient whose SOC is not certified through the Medi-Cal eligibility verification system will be denied. Learn More Medi-Cal.ca.gov

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