What’s the Difference Between Medicare and Medi-Cal?

Both Medicare and Medi-Cal provide health insurance to Americans, but they do it in various ways for different groups. Medicare covers people 65 and older or those with a severe handicap regardless of their income, whereas Medi-Cal (California’s state-run and funded Medicaid program) covers low-income families, pregnant women, and the blind, among others.

What Exactly Is Medicare?

President Johnson brought Medicare into law in 1965 as a federal health insurance program to help Americans over the age of 65 pay for medical expenses. Since then, Medicare has grown exponentially to cover additional services and cover a larger number of patients, including young people who are eligible for Social Security Disability benefits and those with end-stage renal illness.

Medicare is now divided into four divisions, each of which offers different types of coverage and packages:

Part A of Medicare covers inpatient hospital and nursing facility stays, as well as hospice and some in-home healthcare services. While the individual was employed, paycheck deductions paid the majority of the Part A premiums.

Part B of Medicare covers doctor visits, medical supplies, and outpatient treatment (including preventive services). There is a monthly contribution, however it is normally deducted from social security income. (Medicare Parts A and B are sometimes referred to as “Traditional Medicare” or “Original Medicare” when used together.)

Part C, sometimes known as a “Medicare Advantage Plan,” is a private insurer-sponsored alternative insurance plan that combines traditional Medicare and prescription medication coverage into a single policy.

Part D is a Medicare supplement that covers prescription drugs for those with Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. The federal government subsidizes the premiums for this plan, which may be purchased through private firms.

What Exactly Is Medi-Cal?

Medi-Cal offers low-income people and families with health coverage that is either free or much less expensive than the plans offered by Covered California. Medi-Cal plans, like all other plans available via the Health Exchange, must provide specified “essential health benefits,” such as emergency treatments, hospitalization, mental health services, and addiction treatment.

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Individuals and families whose household income is equal to or greater than 138 percent of the poverty level are eligible for Medi-Cal payments. Individuals may also be eligible for Medi-Cal if they meet any of the following criteria:

  • Blind
  • Disabled
  • People aged over 65
  • Pregnant women
  • People aged under 21
  • People in a nursing home or an intermediate care facility
  • Have received limited refugee status
  • Have received breast and/or cervical cancer screening

Individuals who are enrolled in any of the following programs are also eligible for Medi-Cal benefits:

CalWorks (AFDC)

Cal Fresh

Refugee Assistance

SSI/SSP

Foster Care or Adoption Assistance Program

Individuals who are eligible can apply online at CoveredCA.com to see whether they are eligible. Those who meet the criteria will be given a benefits identity card (BIC) to use to begin receiving healthcare services.

Participants in Medi-Cal will also receive a package outlining 21 different health plans from which to pick, however possibilities may vary based on where you and your family live. Regardless of where you reside, Medi-Cal programs in each country provide high-quality treatment at a low or free cost.

News Reporter