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


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