Options for Dual-Eligible Participants
I'm Eligible for Both Medicare and Medi-Cal
Cedars-Sinai has served the needs of MediCal beneficiaries since the program began in 1965. Cedars-Sinai is available to individuals who have are dually-eligible (meaning you have both Medicare and MediCal) whether through traditional Medicare with a MediCal Managed Care plan or through the Cal MediConnect program.
For more information on coverage, see the option that best describes your situation.
In April 2014, California launched a test program called Cal MediConnect in Los Angeles and seven other counties, for individuals who have both Medicare and MediCal. The program is voluntary and you can decide to enroll or opt-out at any time with 30 days notice by calling Health Care Options, which is a branch of the state’s Medi-Cal Managed Care Division, at 844-580-7272; TTY users, 800-430-7077.
With Cal MediConnect, your Medicare and Medi-Cal services are bundled together and coordinated through one plan. To learn more about the benefits you can receive under Cal MediConnect, please visit calduals.org. Health plans include L.A. Care, CareMore, Health Net, Molina and Care 1st.
Cedars-Sinai is participating in Cal MediConnect through the L.A. Care Health Plan. If you choose L.A. Care Health Plan through Cal MediConnect and select a Cedars-Sinai primary care physician, all of your care is provided at Cedars-Sinai and by a narrow network of doctors affiliated with Cedars-Sinai.
If you want to keep your current physician(s), prior to joining Cal MediConnect, please check to make sure they are participating in the Cal MediConnect L.A. Care Health Plan before joining. Since not all physicians are participating, it could mean that you would lose coverage for your doctor even though you will still have coverage for Cedars-Sinai Medical Center.
To find out if your physician is included in this plan, call 1-800-CEDARS-1 (1-800-233-2771), available 24 hours a day.
Individuals who opted out or did not sign up for Cal MediConnect, keep traditional Medicare benefits and have coverage for Cedars-Sinai and many of Cedars-Sinai doctors.
You likely needed to sign up for a Medi-Cal managed care health plan for your Medi-Cal coverage. The Medi-Cal managed care plan is responsible for covering Medi-Cal benefits, long-term support services and coordinating with Medicare for deductibles and coinsurance.
To find out if your physician accepts traditional Medicare, call 1-800-CEDARS-1 (1-800-233-2771), available 24 hours a day.
Cal MediConnect is voluntary and you can decide to enroll, change health plans or opt out at any time with 30 days notice by calling Health Care Options, which is a branch of the state’s Medi-Cal Managed Care Division, at 844-580-7272; TTY users, 800-430-7077.
Individuals who opt-out of Cal MediConnect will keep traditional Medicare benefits and have coverage for a Cedars-Sinai and a larger network of doctors and hospitals. You will likely need to sign up for a Medi-Cal managed care health plan for your Medi-Cal coverage. The Medi-Cal managed care plan will be responsible for covering Medi-Cal benefits, long-term support services and coordinating with Medicare for deductibles and coinsurance.
If you have questions about coverage or referrals, we’re here to help.
Available 24 hours a day, 7 days a week.
Find a list of websites and phone numbers to assist those eligible for both Medicare and Medi-Cal.
Get definitions to terms, abbreviations and acronyms related to billing, insurance and financial assistance.
Frequently Asked Questions
Qualify for both Medicare and Medi-Cal? Find answers to the most common questions about dual-eligible insurance.