Can I use Medi-Cal as secondary insurance?

Families who already have health insurance coverage for their child can still benefit from Medi-Cal as it may be used as a secondary insurance to pay certain expenses that your primary health insurance doesn’t cover.

First, you need to make sure your physician, facility, or service accepts straight Medi-Cal. If they do, they can bill your primary insurance before billing the amount not covered to Medi-Cal. For services or supplies that aren’t completely covered by your primary insurance, you will need a written denial of coverage from your primary insurance as well as a prescription or order from your doctor showing that the service, medication, or supplies are medically necessary.

Director of Health Plan Advocacy Leslie Lobel says that there are a few places that Medi-Cal works well as a secondary:

• ABA: A lot of providers accept Medi-Cal to offload the onus of co-pays on families.
• Durable medical equipment like wheelchairs and standers as well as incontinence supplies like diapers
• Prescriptions
• Hospital-based services: ER visits, inpatient admissions
• Services that take place in pediatric hospital setting (e.g. Children's Hospital) for clinic-based services: behavioral or neurological services or a specialist that your child needs to see (developmental pediatrician). But for intervention services like speech therapy and occupational therapy, it's challenging to find providers who accept Medi-Cal.

For more information, check out our article Making the Most of Medi-Cal.