Is IEHP Medicare or Medicaid? Understanding Which Program It Is

IEHP is a Medicaid managed care plan, not Medicare

IEHP (Inland Empire Health Plan) is a Medicaid health plan, not a Medicare plan. It serves people who are enrolled in California's Medicaid program, which is called Medi-Cal. If you have IEHP, you are covered through Medicaid, not Medicare, even if you are over 65.

This matters because Medicare and Medicaid are completely separate programs with different rules, covered services, and costs. IEHP operates only in specific California counties — primarily San Bernardino and Riverside counties — and only for people who meet Medicaid income and may be able to access rules.

If you arrived at this page from Medicare information, you may have IEHP by mistake, or you may have both IEHP and Medicare at the same time. The section below explains how to tell the difference.

Key Takeaways

IEHP is a Medicaid managed care plan that serves people in San Bernardino and Riverside counties who meet Medicaid income limits.
You cannot have IEHP if you are only on Medicare; you must be enrolled in Medi-Cal (California Medicaid) to use IEHP.
Some people have both Medicaid and Medicare at the same time, and in that case IEHP would be their Medicaid plan while a separate Medicare plan covers Medicare services.
Your insurance card will say "Medi-Cal" or "Medicaid" if IEHP is your plan; it will not say "Medicare".
If you are unsure which program you are in, call the number on your insurance card or contact your county's social services office.

How to tell if you have IEHP or Medicare

The fastest way to know is to look at your insurance card. If it says Medi-Cal or Medicaid anywhere on it, you have IEHP as a Medicaid plan. If it says Medicare, you do not have IEHP — you have a Medicare plan instead.

Your card will also have a customer service phone number. Call that number and tell them you want to confirm whether you are in Medicare or Medicaid. They can answer in less than a minute. You can also check your county's social services website or call your county's may be able to access office directly.

If you have both a Medi-Cal card and a Medicare card, you are dual may be able to access — you have both programs. In that case, IEHP would be your Medicaid plan, and you would have a separate Medicare plan (such as a Medicare Advantage plan or Original Medicare) for your Medicare coverage.

What IEHP covers and what it does not

IEHP covers the services that Medicaid covers in California: doctor visits, hospital care, prescription drugs, emergency services, and preventive care. The exact services and costs depend on which Medi-Cal program you are in — there are several types, including regular Medi-Cal, Medi-Cal for pregnant people, and Medi-Cal for seniors and people with disabilities.

IEHP does not cover Medicare services. If you are over 65 and have both IEHP and Medicare, your Medicare plan covers things like Part B doctor visits and Part D prescription drugs (if you have that coverage). Your IEHP plan covers Medicaid services that Medicare does not, such as long-term care and dental care for adults.

To know exactly what your IEHP plan covers, call the number on your card or log into your account on the IEHP website. You can also ask your doctor's office — they can tell you what IEHP will pay for.

Why someone might confuse IEHP with Medicare

IEHP serves many seniors and people with disabilities, which is why it can seem like a Medicare plan. However, being over 65 does not automatically put you in Medicare — you have to sign up for it. Some people over 65 have only Medicaid (IEHP), some have only Medicare, and some have both.

The confusion also happens because both Medicare and Medicaid are federal health programs with similar names. But they are run by different agencies, have different rules, and cover different people. Medicare is for people 65 and older (and some younger people with disabilities), while Medicaid is for people with low income, regardless of age.

If you are over 65 and have IEHP only, you may want to talk to someone about whether you should also sign up for Medicare. You can contact your local Area Agency on Aging or call 1-800-MEDICARE to learn more.

What to do if you think you should have Medicare instead

If you are 65 or older and do not have Medicare, you can sign up during the General Enrollment Period (January 1 through March 31 each year). You can also sign up during your Initial Enrollment Period, which is the seven months around your 65th birthday.

If you missed your enrollment window, you may have to pay a late penalty when you do sign up. However, some people are exempt from the penalty — for example, if you were still working and had health insurance through your job, or if you are a U.S. citizen who was living abroad.

To sign up for Medicare or to ask whether you need it, call 1-800-MEDICARE or visit Medicare.gov. You can also go to your local Social Security office in person.

If you have both IEHP and Medicare

If you are dual may be able to access (you have both Medicaid and Medicare), you will have two separate insurance cards and two separate plans. Your IEHP card covers your Medicaid benefits, and your Medicare card covers your Medicare benefits. When you go to the doctor, tell them you have both and show both cards.

Your doctor's office will bill both plans. Usually Medicare pays first, and then Medicaid pays any remaining cost that Medicare did not cover. This is called coordination of benefits. You should not have to do anything — the two plans coordinate automatically.

If you have questions about which plan should pay for something, call the customer service number on the card for the plan you think should pay. They can tell you whether that service is covered and who will pay.

Frequently Asked Questions

Can I have IEHP if I am on Medicare?

You can have both IEHP and Medicare at the same time if you meet the income requirements for Medicaid. However, you cannot have IEHP as your only insurance if you are may be able to access for Medicare — IEHP is a Medicaid plan, not a Medicare plan. If you are 65 or older, you should sign up for Medicare even if you also have Medicaid.

Does IEHP work outside of San Bernardino and Riverside counties?

IEHP only serves people in San Bernardino and Riverside counties. If you move out of those counties, you will need to switch to a different Medicaid plan in your new county. Contact your new county's social services office or call Medi-Cal to find out which plans are available where you live.

What if my IEHP card says Medicare on it?

Your IEHP card should not say Medicare on it — it should say Medi-Cal or Medicaid. If it does say Medicare, call the number on the card right away. You may have been enrolled in the wrong plan, or there may be an error on your card.

How do I know if I am may be able to access for IEHP?

IEHP is for people who are enrolled in Medi-Cal (California Medicaid) and live in San Bernardino or Riverside counties. To know if you are may be able to access for Medi-Cal, contact your county's social services office or call 1-888-942-6342 (Medi-Cal customer service). They can tell you whether you meet the income and other requirements.

Can I switch from IEHP to a Medicare plan?

If you have both IEHP and Medicare, you can change your Medicare plan during Medicare's open enrollment period (October 15 through December 7 each year). You cannot change your Medicaid plan (IEHP) unless you move out of the service area or have a may have access to life event. Contact IEHP or your county social services office to ask about changes to your Medicaid coverage.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.