Medi-Medi Plan Guide: Medicare and Medi-Cal in One Plan

If you have both Medicare and full Medi-Cal, a Medi-Medi Plan lets you get both sets of benefits through one plan that coordinates them. It’s a kind of Medicare Advantage plan called a Dual Eligible Special Needs Plan, or D-SNP. Enrollment is voluntary, so you decide whether one makes sense for you.

Below, we explain what dual eligibility means, how these plans work, what changed in 2025 and 2026, and the questions to ask before you join.

What dual eligibility means

Being “dual eligible” means you have both Medicare and Medi-Cal, California’s Medicaid program. Medicare is health insurance for people 65 and older and certain younger people, such as those with disabilities. Medi-Cal helps people with limited income and resources.

People who are dual eligible in California generally fall into two groups. If you’re not sure which group you’re in, your county social services office can tell you.

Full dual eligibility

You have Medicare and full Medi-Cal benefits. This is the group these plans are designed for.

Partial dual eligibility

You have Medicare, and Medi-Cal helps only with your Medicare costs through a Medicare Savings Program. The state runs these programs through Medi-Cal and your county social services office:

• QMB (Qualified Medicare Beneficiary): helps pay Part B premiums, plus Medicare deductibles and coinsurance.
• SLMB (Specified Low-Income Medicare Beneficiary) and QI (Qualifying Individual): help pay Part B premiums.

People with Medi-Cal, a Medicare Savings Program or SSI get Extra Help with Medicare drug costs automatically. Our guide to Extra Help and Medicare Savings Programs explains both.

	Full dual eligibility	Partial dual eligibility
What you have	Medicare and full Medi-Cal	Medicare, plus a Medicare Savings Program (QMB, SLMB or QI)
Extra Help with drug costs	Yes, automatically	Yes, automatically
Can join a Medi-Medi Plan	Yes, if one is offered in your county	No. These plans are for people with full Medi-Cal.
Monthly plan changes	Can move to Original Medicare with a drug plan, change drug plans, or join an integrated plan	Can move to Original Medicare with a drug plan, or change drug plans

What is a Medi-Medi Plan?

It’s a type of Medicare Advantage plan for people who have both Medicare and full Medi-Cal. Instead of keeping track of two programs separately, you have one plan that coordinates the benefits of both.

Like other Medicare Advantage plans, these plans are offered by private companies that contract with Medicare. Each plan has its own provider network and drug list, and benefits vary by plan. Details are in each plan’s Evidence of Coverage.

To join, you generally need Medicare Part A and Part B and full Medi-Cal, and you need to live in the plan’s service area. Joining is voluntary. You can keep getting your benefits the way you do now if that works better for you.

Medi-Medi Plan counties: more starting in 2026

Starting in 2026, these plans are offered in more California counties. The plans available differ by county, so check the list of plans by county from the California Department of Health Care Services (DHCS) to see what’s offered where you live.

Changing plans: the monthly option since 2025

Since 2025, people with Medi-Cal or Extra Help can make a change once a month. You can:

• Switch to Original Medicare with a stand-alone Medicare drug plan.
• Switch from one stand-alone drug plan to another.
• If you have full Medi-Cal, join an integrated plan that coordinates both programs.

Changes start the first day of the next month. For example, a change you make in March starts April 1. You can still use Annual Enrollment (October 15 – December 7) and other Medicare Special Enrollment Periods when they apply.

This monthly option means a decision isn’t locked in for the whole year. Even so, it’s worth comparing carefully before you switch, because each change can mean a new network and a new drug list.

Keep your Medi-Cal current

These plans are for people who have both Medicare and full Medi-Cal, so keep up with your Medi-Cal renewals. Answer renewal letters from your county by the due date, and let the county know if your address changes.

California reinstated a Medi-Cal asset limit on January 1, 2026. It applies to Medi-Cal programs that cover most people 65 and older and people with Medicare. Our article on the 2026 Medi-Cal asset limit explains who it affects and when you report your assets. If your Medi-Cal changes, ask your plan and your county office how it affects your coverage.

What to ask before you join

Bring these questions to a licensed agent, HICAP or the plan itself:

1. Is a plan offered in my county? Check the DHCS list.
2. Are my doctors, specialists and hospitals in the network? Ask about each one by name.
3. Are my prescriptions on the drug list? Check every drug and dose, and ask about your pharmacy.
4. How will my Medi-Cal benefits be handled? Ask what changes for your Medi-Cal coverage if you join.
5. Who helps coordinate my care? Find out who to call with questions and how to reach them.
6. What extra benefits are included? Look for dental, vision, hearing and other benefits in the Evidence of Coverage.
7. Can I get help in my language? Ask whether member services and plan materials are available in Spanish or the language you prefer.
8. What if I change my mind? Confirm how the monthly change option would work for you.

If you or a family member needs a nursing facility level of care, PACE may be another option. See our guide to PACE in California.

For one-on-one counseling at no charge, call HICAP, California’s Health Insurance Counseling & Advocacy Program (1-800-434-0222). You can also call Medicare at 1-800-MEDICARE (TTY 1-877-486-2048) or visit Medicare.gov.

Frequently asked questions

What is the difference between Medicare and Medi-Cal?

Medicare is federal health insurance for people 65 and older and certain younger people, such as those with disabilities. Medi-Cal is California’s Medicaid program for people with limited income and resources. Many people have both, which is called being dual eligible.

Do I have to join a Medi-Medi Plan?

No. Enrollment is voluntary. You can compare these plans with your other options and decide what works for your doctors, prescriptions and care needs.

Is a D-SNP the same thing?

A Dual Eligible Special Needs Plan is a Medicare Advantage plan for people who have both Medicare and Medicaid. The plans described in this article are one type. When you compare special needs plans, ask how each one works with your Medi-Cal benefits.

Can I leave the plan later?

Yes. Since 2025, people with Medi-Cal or Extra Help can change once a month, for example by moving to Original Medicare with a stand-alone drug plan. The change starts the first day of the next month.

Talk with a licensed Boomers agent

A licensed Boomers agent can go over the Medicare plans we represent in your area and check them against your doctors and prescriptions.

Find a licensed agent near you · See upcoming Medicare events

Or call 1-800-815-1943 (TTY 711), Monday – Friday, 9 AM – 5 PM Pacific.

Sources

• Medi-Medi Plans (California Department of Health Care Services)
• Special Needs Plans (Medicare.gov)
• Special Enrollment Periods (Medicare.gov)
• Medicare Savings Programs (Medicare.gov)
• Extra Help with Medicare prescription drug costs (SSA.gov)
• Medicare Counseling (HICAP) (California Department of Aging)