MEDI MEDI options in Los Angeles

Many don't realize that there are Medicare Advantage plans specifically designed for them with one goal...to reduce out-of-pocket expense!

We'll jump into the pros of thess plans as well as the medi medi world itself.

A quick note...it's always best to compare the options including medi medi options in your area.  Our online quote system will allow you to see plans from major carriers with D-SNP plans (Dual Eligible):

We really go through how to compare Advantage plans and offer our Insider's Guide to Advantage plans but medi-medi is a special sub-section!

You can always jump right to a section here:

• What is medi medi
• How can I have medicare and medical
• Medi medi eligibility
• Are medicare and medical the same
• Quick look at medicare
• Quick look at med-cal
• Medicare Advantage plans (HMO's)
• How to quote the medi medi plan
• How to enroll in the medi medi plan
• Review medi medi

You can always request your quote below (we'll send you follow-up link for doctor/RX info and "opt-in" called Scope of Appointment which is required by law to quote Advantage and Part D:

What is medi medi?

Medi medi is the short-hand term for having Medicare and Medi-cal at the same time.

• Generally speaking, Medicare is based on either age (65 and over) or permanently disable status.
• Medi-cal (Medical) is the California version of medicaid which is generally based on income and assets.

It's possible for people to be eligible for both at the same time.

Hence the term medi medi!

The two plans will generally coordinate benefits or out of pocket costs together for people who are eligible.

You can then get medi medi Advantage health plans separately from a private carrier to fill in the holes of medi medi coverage.

That's where medi medi plan comes into play.

More on that later.

How can people have both at the same time?

How can I have medicare and medical

It's true...most people have Medicare OR they have Medi-cal.

There is an overlap and 100's of thousands in California qualify!

Just look at Los Angeles at the bottom:

30% of Medicare eligible are also Medi-cal eligible. That's almost 500K people!

We basically need to be eligible for both programs separately but at the same time.

• Keep in mind that Medicare is a Federal program solely administered by the Federal government.
• Medi-cal is the California administered arm of Medicaid, also a Federal program.

Medicare is generally the first step.  Check with your local county to see if you qualify for medi-cal (contacts here)

Let's get right into the eligibility side of each one.

Medi medi eligibility

Let's look at each piece separately.

This is a quick overview (definitely check with the county for Medi-cal and Social Security for Medicare). There's lots of detail but we want give you jumping off point.

Medi-cal eligibility as it applies to dual eligibles.

This is just a summary...really reach out to your local county Medi-cal office!

First, you need to qualify based on assets.

Generally speaking, you can't have over $2000 in assets as an individual or $3000 as a couple.

They do not include the following:

• Your primary home
• One vehicle
• Household goods and personal belongings
• Life-insurance policy with a face value of $1,500 per person
• Prepaid burial plan (unlimited if irrevocable or up to $1,500 if revocable) and burial plot

If we pass the asset qualification, they then look at income.

This depends on a few factors but you can get more information here.

You'll notice that there are little break-outs from the core income qualification based on such things as disability.

If you qualify for SSI (permanently disabled or blind), you may automatically qualify for full Medi-cal.

Ultimately, you'll have to apply for medi-cal which you can do right through the link or by contacting them directly.

If you're eligible for Medicare, you wouldn't apply for medi-cal through Covered California.

That's the Medi-cal piece.  Check with the county!   There can be many different situations!

We also need Medicare!

Medicare eligibility for California dual eligible medi medis

Medicare eligibility is generally triggered 1 of 2 ways:

• Permanent disabled status or blind
• Age 65 and over

Permanent disabled status is the SSI we mentioned above.

For people age 65 and over who do not have disabled status or who are not blind will then qualify for the medi-cal piece based on asset/income.

You can find more on enrolling for Medicare here.

Once you have Medicare and Medi-cal together, we can get to work on the medi medi health plans!

A few more quick questions we typically get.

Are medicare and medi-cal the same?

This is a common question.

The quick answer is NO!

Medicare is a Federal program to provide health coverage to:

• Individuals under age 65 who are permanently disabled or blind
• Individuals age 65 and over who are eligible

Medi-cal is California's version of Medicaid which provides coverage and assistance to:

• Individuals who qualify based on income and assets
• Individuals who are SSI (permanently disabled or blind)

They are two separate plans altogether but they can coordinate for certain individuals who qualify for both.

That's where the medi medi or dual eligible plans come into play.

Let's look at each piece in more detail before discussing the medi medi plans to fill in holes.

Quick look at medicare as it applies to medi medi

Medicare is comprised of a few parts:

• Part A - Hospital and Facility
• Part B - Physicians charges
• Part D - Medication

These are the big pieces.

There's are holes in the coverage.

Medicare generally works like an 80/20 plan with deductible built in.

We want to address those holes in coverage...especially the 80/20 piece.

The deductibles are fixed but who wants to pay 20% of $100K?

This is an important gap in Medicare that needs to be addressed with a medi medi plan.

Learn more about what Medicare covers (and doesn't).

What about the other piece of medi medi? Medi-cal?

Quick look at medi-cal for Medi Medi.

Medi-cal kicks in with assistance for people with Medicare in two ways generally:

• Helps with share of cost or towards medical out of pocket expenses
• Helps with insurance cost

The point is that if you're eligible for medi-cal and Medicare, they will work together to reduce your out of pocket costs!

Let's look at the next piece towards medi medi plan coverage.

Medicare Advantage plans (HMO's)

Medicare Advantage plans are the Medicare equivalent of HMO plans.

HMO plans require more management of care in terms of who you can see (doctors) and how care is administered.

The trade off is low or no cost premium for these plans.

That makes them very popular versus Medicare supplements.

You can find out more about Medicare supplements versus Advantage plans here.

For Medi medi's, the dual eligible coverage is through Advantage plans.

Let's now look at how to see the plans in your area

Qoting medi-Medi plans in your area

You can always run your Medicare Advantage Plan quote:

After clicking on the "Advantage Plan" tab,  click on "All all Special Need Plans":

Check out the benefits for local Medi-medi plans through the quote.

In addition to the core benefits, there may be add-ons depending on your area and what's available:

• Dental
• Vision
• Hearing
• Fitness
• RX
• Acupuncture
• Preventative
• Personal Emergency Response
• Podiatry
• Worldwide Emergency
• Nurse Helpline
• Live health

Make sure to check current benefits for changes!

Medi medi plan providers

With any Advantage plan, it's really important to check (and like) the doctors.

By definition, we have to stay in-network with an Advantage plan if HMO (most are).

You can add your doctors AND medications through the quote.  The system will rank the plans according to this info!

We're happy to research providers for you as well so feel free to reach out to us by email.

How to quote the medi medi plan

The best way to quote Medi Medi plan to request a Medicare plan quote here.

• Select the "Advantage quote"
• Click on the Advantage Tab
• Add all Special Need Plans

With that info, you can generate a personalized quote for your situation!  Make sure to note that you're interested in medi-medi with any questions to us at help@calhealth.net  

Again, you need medi medi or dual eligible status for this plan.  There's ZERO cost for our assistance and as a show of faith...

How to enroll in a medi medi plan

If you want to enroll in a medi medi plan, we can assist.

At no cost to you!

This is our favorite part.  Right through the quote above, most carriers will allow online enrollment with the "Add to Cart" feature by your chosen plan.

If you don't see this or need additional help, email us at help@calhealth.net with questions or set up a time to speak.

Your information will be in the system for annual open enrollment to quickly update (doctors, meds, etc), re-quote, and even switch plans!

Review on medi medi

Medi Medi plans are an exciting option if you're dual eligible!

• Super low copays
• Add-on benefits that actually matter
• Low or no-cost pricing

This is a definite consideration for people with dual medi medi status where available.

If you would like more information, please request this via email here.

All assistance for Medicare Advantage Plans is through a dedicated agent and check out the Google Reviews:

Advantage plans have very specific rules, requirements, and protections. 

There is no cost to you for our services!   A licensed representative can help you with any questions from there.

 Quote Advantage plans for Medi Medi to view rates and plans side by side for both carriers...Free.