Recent media coverage has suggested that people enrolled in both Medicare and Medi-Cal — referred to as dually eligible individuals — have limited options for their Medicare coverage. That claim is incorrect.
Dually eligible Californians continue to have multiple, meaningful options, including Original Medicare, Medicare Advantage plans, a Medi-Medi Plan, or PACE (Program of All-Inclusive Care for the Elderly). These options are not going away; they remain fully available to members. No matter which path they choose, dually eligible individuals maintain access to full-scope benefits covered by Medicare and Medi-Cal.
What has changed under the state Department of Health Care Services’ California Advancing and Innovating Medi-Cal (CalAIM) initiative is our focus on improving care coordination for people with complex needs.
Many dually eligible individuals live with serious health conditions, need help with daily activities, or face barriers like limited income or lack of transportation. Navigating two separate delivery systems can be overwhelming for these individuals and their families and caregivers.
Medi-Medi Plans address that fragmentation by aligning Medicare and Medi-Cal benefits under one plan. This model simplifies care with one member identification card, one care team, and integrated services across medical, behavioral health, and long-term services and supports. Better coordination helps members get the right care at the right time, and it helps caregivers and clinicians work from the same information, so treatment plans are consistent across both delivery systems.
For dually eligible Californians and the people who support them, the bottom line is simple: You still have choices. The CalAIM initiative is not about limiting options; it’s about making those options work better together. If you want to stay in Original Medicare, you can. If you prefer a Medicare Advantage plan, you can enroll during Medicare’s open enrollment period. If a Medi-Medi Plan’s integrated model sounds right for you, that pathway is available in many counties today and expanding to more communities in the future. And if you qualify for PACE, you can choose a model designed specifically to integrate medical care and social supports for older adults living at home.
Transparency and public engagement are central to how the Department of Health Care Services implements policy. We communicated these changes through public webinars, stakeholder workgroups, press releases, and continuously updated webpages and resources, including the Medi‑Medi Plan webpage, so members, advocates, providers, and local officials can see what’s available now and what’s coming next.
Dually eligible Californians deserve a system that is easier to navigate and delivers coordinated, high-quality care. That is what Medi-Medi Plans are designed to do, and it’s why the Department of Health Care Services is working with plans and providers across the state to expand aligned, person-centered options, preserving member freedom to choose the coverage that fits their needs.
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