Eligibility

Who Can Join a Cal MediConnect Health Plan?

If you have both Medicare and Medi-Cal (meaning you are a dual-eligible beneficiary, also known as Medi-Medi), you may qualify for Cal MediConnect.

Cal MediConnect is only available in seven participating counties: Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.

Most people with full Medicare and Medi-Cal benefits can join a Cal MediConnect health plan, but there are some exclusions.

You do not qualify to join Cal MediConnect if you:

  • Are younger than 21.
  • Have partial benefits or other health coverage.
  • Are enrolled in a Home and Community Based Services waiver (except Multipurpose Senior Services Program [MSSP]; all others must disenroll from all other HCBS programs to be eligible for the Cal MediConnect).
  • Have developmental disabilities.
  • Have End-Stage Renal Disease (exception for San Mateo & Orange counties).
  • Are enrolled in PACE and/or AIDS Health Care Foundation (you must disenroll from these programs to be eligible for the Cal MediConnect).