Patients with Medi-Cal or Medicare Coverage

If you are currently uninsured, you may qualify for Medi-Cal or Medicare coverage.

Facts About Medi-Cal

Medi-Cal is an insurance program jointly funded by your state and federal government. Patients have 90 days from dateof treatment to apply for Medi-Cal; this applies to inpatient and outpatient treatment.

Eligibility is Determined by:

1. Disability due to medical reasons
2. Number of minor children (under the age of 18) in the home
3. Inability to return to work for four months or more
4. Pregnancy
5. Income
6. Assets

For more info visit www.medi-cal.ca.gov/ or contact the Patient Financial Services department at (559) 638-8155.

Facts about Medicare

Medicare is a federally funded health insurance program for people age 65 or older, some people with disabilities underage 65, and people with End-Stage Renal Disease. Medicare has 2 parts, Part A and Part B. Part A is hospital insurance -most people do not pay for Part A coverage. Part B is medical insurance – most people pay monthly for Part B coverage.

If you qualify for Medicare, you also have the option of choosing a Medicare + Choice plan, which is a managed care planadministered by a private company that replaces your Medicare coverage.

There are limitations on a number of services and items covered by Medicare and Medi-Cal, depending on the plan youhave. You are responsible for copayments, deductibles, and other services not covered. If your Medicare or Medi-Calcoverage is through an HMO, it is important that you bring this to our attention.

Medicare Premiums and Deductibles/Copayments

Premiums and Deductibles/Copayments are based on the number of quarters of Medicare-covered employment therecipient has when they are awarded Medicare and on the type of services you are provided.

Medicare Does Not Cover the Following Services (you must pay the full cost yourself):

• Private duty nursing
• Most prescription drugs
• Custodial care, unless skilled nursing is provided at the sametime
• Most chiropractic services• Cosmetic surgery
• Care outside of the United States
• Acupuncture
• Eyeglasses, except after cataract surgery
• Dental Care

For more information regarding Medicare, call (800) 633-4227 (800-Medicare), or visit www.medicare.gov.