Some people qualify for both Medicare and Medi-Cal and are “dual eligible" beneficiaries. Like all Medicare beneficiaries, dual eligible beneficiaries can choose whether to receive care through Original Medicare, or enroll in a Medicare Advantage (MA) plan, sometimes called “Part C" or “MA Plans." In California there are several types of Medicare Advantage. Local HICAP organizations can provide assistance.
For Medi-Cal benefits, most dual eligible beneficiaries are enrolled in Medi‑Cal managed care plans. Enrollment in a Medi-Cal managed care plan does not impact Medicare benefits or provider access.
Medi-Medi Plans coordinate all benefits and services across both programs, including all Medicare
and Medi-Cal covered services.
Medi-Cal Matching Plan Policy
To address the challenges for beneficiaries of coordinating across different health plans for Medicare and Medi-Cal benefits, DHCS has a Medi-Cal matching plan policy in 17 counties in 2025. Under this policy, a beneficiary's Medicare plan choice is the lead, and the Medi-Cal plan follows. This means that for dual eligible beneficiaries that choose to enroll in a MA plan in those counties, their Medi-Cal plan must align with their MA plan choice, if there is a Medi-Cal plan affiliated with their MA plan. The Medi-Cal matching plan policy does not change or impact a beneficiary's MA plan choice. The beneficiary notice is here.
Note: For additional information on the 2023 policy, view the Medi-Cal Matching Plan Policy Scenarios slides. These slides provide visuals on four common scenarios that generally apply to dual eligible beneficiaries.
The 17 counties with the Medi-Cal matching plan policy in 2025 are: Alameda, Contra Costa, Fresno, Kern, Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Mateo, Santa Clara, Stanislaus, and Tulare counties. In 2026, the Medi-Cal matching plan policy will be implemented in all counties
For beneficiaries with questions about the Medi-Cal matching plan policy, please contact Medi-Cal Managed Care Health Care Options: Home | Medi-Cal Managed Care Health Care Options
Additional contact information is available at the Medi-Cal Health Care Options website.
