By Joe W. Bowers Jr., California Black Media
For decades, Medi-Cal has played a vital role in California’s healthcare infrastructure. Today, it provides health coverage to more than 15 million people, representing about 40 percent of the state’s population.
This includes 1.6 million people dually eligible for Medicare and Medi-Cal.
Medi-Cal, California’s version of the federal program Medicaid, has piloted a program in several counties, including Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, Santa Clara, Fresno, Kings, Madera, Sacramento, and Tulare, that presents an option for Californians who qualify for both Medi-Cal and Medicare. By 2026, the Department of Health Services aims to make the program available to eligible individuals in all counties.
Transforming Medi-Cal: A Vision for Better Health Care
Medi-Cal transformation focuses on improving health care coordination, integration, quality, equity, and accessibility.
A key component of this broader vision to enhance healthcare access and improve health outcomes for Californians is Medi-Medi Plans, a type of Medicare Advantage plan. Medi-Medi Plans are designed to coordinate care for people who qualify for both Medicare and Medi-Cal by combining their Medicare and Medi-Cal benefits into one plan.
Medicare and Medi-Cal operate separately, with different benefits and plans. This fragmented system can be confusing, hard to navigate, and may not provide person-centered services. Medi-Medi Plans are helping integrate care for members dually eligible for Medicare and Medi-Cal.
Key Features of Medi-Medi Plans
In a Medi-Medi Plan, a member’s Medicare plan takes the lead, with Medi-Cal providing wrap-around support.
This integrated approach simplifies access to health care services, allowing qualifying individuals to receive primary care, specialty care, prescription medications, transportation assistance, and other benefits in one coordinated plan.
Features of the comprehensive range of services include:
Dedicated Care Team: Medi-Medi Plans have a dedicated team to assist members in understanding their benefits, scheduling appointments, managing chronic conditions, and accessing preventive care.
Network of Providers: Primary care, specialist services, hospitals, clinics, labs, pharmacies, and medical equipment suppliers are all included in a Medi-Medi Plan’s network, ensuring members can find quality care for various medical needs.
Mental Health Services: Medi-Medi Plans offer access to therapy and counseling. This ensures access to resources essential for stress management, anxiety, depression, and other mental health concerns.
Transportation Assistance: Medi-Medi Plans provide transportation support to ensure members can make it to scheduled medical appointments.
Supplemental Benefits: Medi-Medi Plans may offer extra benefits like dental, hearing, vision, and over-the-counter benefits, in addition to what Medi-Cal covers.
Choosing the Right Plan
For example, Los Angeles County residents have several Medi-Medi Plans to choose from. Available plans include:
- Anthem Full Dual Advantage Aligned – call 833-236-2366
- Blue Shield Total Dual Plan – call 800-452-4413
- L.A. Care Medicare Plus – call 866-522-2736
- Molina Medicare Complete Care Plus – call 800-665-0868
- Kaiser Permanente Senior Advantage Medicare Medi-Cal South P1 – call 800-443-0815
- Wellcare Dual Align – call 800-431-9007
To be eligible to join a Medi-Medi Plan, you must have both Medicare Part A and B and Medi-Cal and must be 21 years of age or older.
Take Charge of Your Health
To help you find the right plan, Los Angeles County offers free support through the Center for Health Care Rights, Los Angeles County’s Health Insurance Counseling and Advocacy Program (HICAP).
To learn more about Medi-Medi Plan eligibility, available plans, and additional resources, contact the Center for Health Care Rights at (800) 434-0222. You can also call your Medi-Cal plan or 1-800-Medicare.
