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Cal MediConnect

Cal MediConnect is a type of health plan that includes all your MedicareThe federal program that provides health care benefits for people age 65 years and older as well as people of any age with certain disabilities or diseases.
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and Medi-CalA government program that offers health care coverage for low-income Californians. (Medi-Cal is the federal-state Medicaid program in California.)
benefits, as well as some extra benefitsPayment of health care services and products. Medicare benefits pay for doctor visits, hospital care, prescription drugs, and some behavioral health services.
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.

  • To qualify for Cal MediConnect, you must have Medicare and Medi-Cal, be 21 or older, and live in one of these counties: Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, or Santa Clara.
  • You get extra help so you can live independently (like having shower grab bars and ramps installed). You have someone, like a nurse or other helper, whose job is to be your main point of contact and help you get all the health care services you need.
  • You have one card to carry and one phone number to call to get help with your care.
  • You have to use providers in your health plan’s network. (If your providersA person or organization that provides health care-related services or products, like a doctor, hospital, clinic, personal care assistant, or equipment supplier.
    are not in the networkA group of doctors, hospitals, pharmacies, and other health care providers that work with your health plan to provide your health care services.
    , you can get help finding providers that are.)

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Benefits 

Benefits

  • Cal MediConnect manages your Medicare + Medi-Cal benefits.
  • You have just one health plan card to carry and one phone number to call about your health care and other services.
  • Cal MediConnect health plans include all your existing benefits (like doctors, hospitals, prescription drugs, medical supplies, medical equipment, nursing facility, and home- and community-based services). They also offer:
    • Extra dental, hearing, and vision coverage
    • TransportationPayment of medically necessary transportation. This can include ambulance, wheelchair van, taxi, ride-share service, or public transportation.
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      help
    • Mental healthServices to promote mental health (like counseling or medication for feelings of sadness or stress).
      and substance use helpServices that help people who are having problems with substances like alcohol or drugs.
    • Extra help so you can live in your home safely (like shower grab bars and ramps)
  • You can get a care coordinatorA nurse, social worker, or other health professional who helps you get and manage all the health care services you need. Also known as a care navigator or case manager.
    . This is a nurse or other helper whose job is to be your main point of contact and help you get all the health care services you need.
  • If you are living in a nursing facilityNursing facilities provide nursing, rehabilitative services, medical care, and long-term services and supports. They include nursing homes and rehabilitation facilities.
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    , you can join Cal MediConnect. If you want, they can help you live independently.

Considerations

  • Cal MediConnect health plans have networksA group of doctors, hospitals, pharmacies, and other health care providers that work with your health plan to provide your health care services.
    of providers (like doctors, hospitals, clinics, labs, and equipment suppliers). The health plan will ask you to see the providers in their network.
    • If your doctor or hospital is not already in the health plan’s network, they might have to join the network, or you may have to change providers. You may also have to change where you get your medical suppliesMedically related supplies often ordered or prescribed by a doctor. They are typically disposable and used once. They include diabetic test strips, oxygen, and incontinence supplies.
      and equipmentReusable equipment ordered or prescribed by your doctor for use at home, like walkers, wheelchairs, hospital beds, and more. Also known as durable medical equipment (DME).
      .
    • Your Cal MediConnect care coordinator can help you find new doctors and providers that meet all your needs.
  • You can keep your Medi-Cal long-term servicesThe federal program that provides health care benefits for people age 65 years and older as well as people of any age with certain disabilities or diseases.
    Full Definition >
    and supports providers. This includes keeping your In-Home Supportive Services (IHSS)IHSS provides in-home care for people who need it to safely live in their own homes.
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    , your adult day centersFacilities that provide social activities and meals and sometimes nursing and therapies during the day.
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    , Multipurpose Senior Services ProgramA program that helps coordinate health care and social services and provides extra support services.
    , or the nursing facility where you reside (if applicable.)

To learn more and find out if you are eligible, contact Health Care Options-Cal MediConnect at 1-844-580-7272 (TTY 1-800-430-7077).

Success Stories 

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Next Steps 

How to Enroll

You have two options to enroll:

  • If you already have a Medi-Cal health plan, call them directly and ask about Cal MediConnect.
  • Call Health Care Options at 1-844-580-7272 (TTY 1-800-430-7077).

Download Helpful Tools

Contact Help Services

Visit our Get Help page for links and phone numbers to people who can help you understand your Medicare and Medi-Cal benefits and assist you in choosing a coverage option.

Explore More About Cal MediConnect

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