Last Updated: September 1, 2026
Can I Have Both Medicare and Medi-Cal? California Guide for 2026
Yes. Many Californians qualify for both Medicare and Medi-Cal at the same time.
People who qualify for both programs are often called dual eligible beneficiaries. Having both programs can provide broader health coverage and may help reduce Medicare premiums, deductibles, copayments, and other health care costs, depending on your eligibility.
This guide explains how Medicare and Medi-Cal work together in California, which program pays first, how prescription drugs are covered, what Medicare Savings Programs can help pay, and what Medi-Medi Plans mean for people who have both programs in 2026.
You can have Medicare and Medi-Cal at the same time if you qualify for both. For Medicare-covered services, Medicare is generally the primary payer. Medi-Cal may help with certain remaining costs and also covers some benefits and services that Medicare does not cover.
1. What Is Medicare?
Medicare is a federal health insurance program primarily for:
- People age 65 and older
- Certain younger people with disabilities
- People with certain qualifying medical conditions
Medicare has several parts:
- Part A – Hospital insurance
- Part B – Medical insurance, including many doctor and outpatient services
- Part C – Medicare Advantage plans offered by private insurance companies approved by Medicare
- Part D – Prescription drug coverage
2. What Is Medi-Cal?
Medi-Cal is California's Medicaid program. It provides health coverage to eligible California residents based on factors such as income, age, household circumstances, disability, pregnancy, and other eligibility rules.
For people who also have Medicare, Medi-Cal can provide important additional coverage and may help with certain Medicare costs.
3. Can I Have Medicare and Medi-Cal at the Same Time?
Yes.
If you meet the eligibility requirements for both programs, you can have Medicare and Medi-Cal at the same time.
This is commonly called dual eligibility.
A person who qualifies for both Medicare and Medicaid is called dual eligible. In California, Medicaid is called Medi-Cal.
4. Which Insurance Pays First?
When you have both Medicare and full-scope Medi-Cal, Medicare generally pays first for services that Medicare covers.
Medi-Cal is generally the secondary payer and may help pay certain costs that remain after Medicare or other insurance has paid.
Medi-Cal may also provide additional benefits and services that are not covered by Medicare.
Having Medi-Cal does not replace Medicare when you become eligible for Medicare. The two programs can work together.
5. Does Medi-Cal Pay My Medicare Part B Premium?
It may, depending on your eligibility.
California has Medicare Savings Programs (MSPs) that can help eligible Medicare beneficiaries pay Medicare costs.
Depending on the program you qualify for, assistance may include:
- Medicare Part A premiums in certain situations
- Medicare Part B premiums
- Medicare deductibles
- Medicare copayments and coinsurance in certain programs
6. What Are the Medicare Savings Programs?
California Medicare Savings Programs include several different eligibility categories.
Qualified Medicare Beneficiary (QMB)
QMB can help pay Medicare Part A and Part B premiums as well as Medicare deductibles, copayments, and coinsurance for eligible beneficiaries.
Specified Low-Income Medicare Beneficiary (SLMB)
SLMB can help eligible beneficiaries pay their Medicare Part B premium.
Qualifying Individual (QI)
QI can also help eligible beneficiaries pay their Medicare Part B premium. QI has different eligibility rules and generally cannot be received at the same time as Medi-Cal.
Qualified Disabled and Working Individual (QDWI)
QDWI may help certain working people with disabilities pay Medicare Part A premiums.
Medicare Savings Program income and asset limits can change from year to year. Even if your income appears slightly above a published amount, it may still be worth applying because certain deductions may apply when eligibility is calculated.
7. What Are the 2026 Medicare Savings Program Income Limits?
DHCS lists the following 2026 gross income figures for California Medicare Savings Programs:
| Program | Individual / Month | Couple / Month | Main Benefit |
|---|---|---|---|
| QMB | $1,330 | $1,804 | Parts A & B premiums and Medicare cost-sharing |
| SLMB | $1,596 | $2,165 | Part B premium |
| QI | $1,796 | $2,436 | Part B premium |
| QDWI | $2,660 | $3,608 | Part A premium |
These are 2026 DHCS published gross income figures. Eligibility calculations may include deductions, and additional program rules apply.
8. Is There an Asset Limit for Medicare Savings Programs in 2026?
Yes.
Beginning January 1, 2026, California uses an asset limit of $130,000 for one person for Medicare Savings Program eligibility.
The limit increases by $65,000 for each additional household member, up to the applicable household maximum.
Assets can include items such as bank accounts, cash, certain additional property, and certain vehicles. Not every asset is necessarily counted in the same way, so an individual eligibility determination is important.
9. What Happens to Prescription Drug Coverage?
If you have both Medicare and full-benefit Medi-Cal, Medicare generally provides your prescription drug coverage through Medicare Part D.
Dual eligible beneficiaries are generally automatically enrolled in Medicare prescription drug coverage if they do not already have appropriate drug coverage.
Medi-Cal may still cover certain medications or services in situations where Medicare does not provide coverage.
10. Can I Keep Original Medicare If I Have Medi-Cal?
Having Medi-Cal does not automatically mean that you must give up Original Medicare.
Dual eligible beneficiaries generally have Medicare coverage choices, which can include Original Medicare or a Medicare Advantage plan, subject to Medicare rules and the options available in their area.
Before choosing a Medicare Advantage plan, check whether your doctors, hospitals, specialists, and medications are included.
11. What Is a Medi-Medi Plan?
A Medi-Medi Plan is a type of Medicare Advantage plan in California specifically designed for people who have both Medicare and Medi-Cal.
The purpose is to coordinate Medicare and Medi-Cal benefits through one organization and care team.
A Medi-Medi Plan includes:
- Medicare Part A benefits
- Medicare Part B benefits
- Medicare Part D prescription drug benefits
- Medi-Cal benefits
- Coordinated care
- Coordination of services such as transportation and long-term services and supports when applicable
Some plans may also offer additional benefits such as dental, hearing, or vision benefits beyond what is otherwise covered.
Medi-Medi Plans expanded to 29 additional California counties in 2026. According to DHCS, eligible members in 41 counties can choose a Medi-Medi Plan in 2026. Plan availability varies by county.
12. Do I Have to Join a Medi-Medi Plan?
Medi-Medi Plans are an option for eligible dual eligible beneficiaries in participating counties, but your Medicare choices and enrollment rules depend on your individual situation.
Do not choose a plan only because it is called a Medi-Medi Plan. Compare your doctors, hospitals, prescriptions, additional benefits, and the plan's service area before enrolling.
13. How Do I Find a Medi-Medi Plan in My County?
DHCS maintains an official county-by-county list of Medi-Medi Plans available in California.
View the 2026 Medicare Medi-Cal Plan List by County
You can also compare Medicare plans through Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
14. What Happens When I Turn 65 If I Already Have Medi-Cal?
Turning 65 does not automatically mean that you should cancel Medi-Cal.
If you become eligible for Medicare, your health coverage situation can change because Medicare may become your primary insurance while Medi-Cal may continue as secondary coverage if you remain eligible.
Your Medi-Cal eligibility may also be reviewed under rules that apply to your new eligibility category.
Do not cancel your Medi-Cal simply because you are enrolling in Medicare. Find out whether you can keep Medi-Cal and whether you qualify for help with Medicare premiums and other costs.
15. How Do I Apply for Help With Medicare Costs?
California allows people to apply for Medicare Savings Programs through the Medi-Cal application process.
You can apply:
- Online through BenefitsCal
- By mail
- By phone through your county social services office
- In person at your county office
If you only want to apply for a Medicare Savings Program, California also provides the MC 14A application.
Learn About California Medicare Savings Programs
Frequently Asked Questions
Can I Have Medicare and Medi-Cal at the Same Time?
Yes. If you qualify for both programs, you can have Medicare and Medi-Cal at the same time. This is known as dual eligibility.
Which One Pays First?
For Medicare-covered services, Medicare is generally the primary payer. Medi-Cal generally pays after Medicare and other applicable insurance and may provide additional covered services.
Can Medi-Cal Pay My Medicare Part B Premium?
It may. Eligible beneficiaries may receive assistance with Medicare premiums through a Medicare Savings Program.
Do I Lose Medi-Cal When I Turn 65?
Not automatically. If you remain eligible for Medi-Cal after becoming eligible for Medicare, you may have both programs.
What Is a Medi-Medi Plan?
A Medi-Medi Plan is a type of Medicare Advantage plan for eligible Californians who have both Medicare and Medi-Cal. It coordinates benefits from both programs through one plan.
Official Resources
- DHCS – Medi-Medi Plans
- DHCS – 2026 Medicare Medi-Cal Plan List
- DHCS – Medicare Savings Programs
- Medicare.gov – Medicare and Medicaid
California Benefits Guide is an independent informational website and is not a government agency or affiliated with Medicare, the Centers for Medicare & Medicaid Services (CMS), the California Department of Health Care Services (DHCS), or any health insurance company. This article is provided for general informational purposes only and does not constitute legal, medical, tax, financial, or insurance advice. Medicare and Medi-Cal eligibility, costs, benefits, and plan availability depend on individual circumstances and may change. For official eligibility decisions and current plan information, contact Medicare, DHCS, or your county Medi-Cal office.