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amother
OP
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 Wed, Jan 10 2024, 10:16 pm
So I live in CA and it is called Medi-cal here. My kids qualify for medi-cal due to income but we have to apply. I have to get a private plan for one kid who needs special medication not covered by medi-cal and even if it was it would take several months for it to get approved and my kid can't wait or take that chance.
So can we apply and then get a private plan too? I am aware medi-cal becomes payor of last resort for Medicare- but does it work for private plans? I was hoping that by getting Medi-cal we get extra coverage for something the primary won't cover and we get access to things like WIC and other benefits.
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amother
Aconite
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Wed, Jan 10 2024, 10:30 pm
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I don't know if it's state specific. I had medicaid and private insurance in Illinois. Private was primary, but medicaid took care of co-pays for in network drs.
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amother
Peach
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Wed, Jan 10 2024, 10:37 pm
You can ask your local JFS or insurance broker.
Btw you most likely have till the end of January to register for 2024. After is much harder or impossible.
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amother
OP
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Wed, Jan 10 2024, 10:44 pm
| amother Peach wrote: | You can ask your local JFS or insurance broker.
Btw you most likely have till the end of January to register for 2024. After is much harder or impossible. |
We have a qualifying event. So we get extra time for 2024.
Asking here because insurance broker doesn't seem to know.
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amother
Catmint
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Thu, Jan 11 2024, 12:03 am
| amother OP wrote: | We have a qualifying event. So we get extra time for 2024.
Asking here because insurance broker doesn't seem to know. |
You need someone familiar with California because both insurance and Medicaid rules vary by state.
In NJ you are allowed to have private commercial insurance along with medicaid, but your commercial insurance is primary and medicaid acts as a secondary. As the secondary insurance, medicaid pays your out of pocket costs for in network providers. If you see someone out of the medicaid network, they will sometimes still cover and sometimes not.
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