Options for Dual-Eligible Participants
Cedars-Sinai has partnered with eHealth to help you find the Medicare coverage that best meets your needs. Speak with a licensed insurance agent or enroll in a plan online.
I'm Eligible for Both Medicare and Medi-Cal
Cedars-Sinai has served the needs of Medi-Cal beneficiaries since the program began in 1965. Cedars-Sinai is available to individuals who are dually-eligible (meaning you have both Medicare and Medi-Cal). There are numerous coverage options available.
For questions regarding dual coverage, please click here.
Effective January 1, 2023, the California Department of Health Care Services’ CalAIM initiative replaced the Cal MediConnect program. CalAIM’s ultimate goal is for a single insurer to be able to coordinate both your Medicare and Medi-Cal benefits. There are multiple benefit plan combinations available:
- Opt-out: Maintain your Original Medicare and standard Medi-Cal coverages. You will be required to assign your standard Medi-Cal coverage to an insurer contracted with your county to administer Medi-Cal benefits. This coverage option provides no coordination of your Medicare and Medi-Cal benefits.
- Medicare Advantage Plan, plus standard Medi-Cal coverage: You may sign up for a Medicare Advantage HMO or PPO plan that does not include your Medi-Cal benefits. If you prefer this option, you must still assign your standard Medi-Cal coverage to an insurer contracted with your county to administer your Medi-Cal benefits. You do not have to assign your Medi-Cal benefits to the same insurer as the one that operates your Medicare Advantage plan. To see which D-SNP HMO plans Cedars-Sinai contracts with, please click here.
- Medicare Medi-Cal Managed Care Plans (MMPs), also known as Dual Special Needs Plan (D-SNP HMO): A D-SNP HMO is an HMO product that combines your Medicare and Medi-Cal benefits into a single benefit plan. To see which D-SNP HMO plans Cedars-Sinai contracts with please click here.
To find out if your physician accepts traditional Medicare, call 1-800-CEDARS-1 (1-800-233-2771), available 7 days a week, 6 am - 9 pm PT.
Program of All-Inclusive Care for the Elderly (PACE) Plans
Cedars-Sinai is contracted with ConcertoPACE for hospital services. To qualify for these services and other PACE programs, you must:
- Be 55 years or older.
- Meet the requirement for skilled nursing home care as determined by an assessment by the PACE organization’s interdisciplinary team.
- Be certified by the California Department of Health Care Services.
- Live in a service area (county and ZIP code) served by a PACE program.
- Be able to live in the community without jeopardizing your health or safety.
If you have questions about coverage or referrals, we’re here to help.
Available 7 days a week, 6 am - 9 pm PT.
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.