Medi-Cal and Medicare are both programs established by the federal government to provide medical and health-related services to United States citizens. Both programs were created by a 1965 amendment to the Social Security Act and are managed by the Centers for Medicare and Medi-Cal Services.
What is Medi-Cal?
Medi-Cal is a healthcare assistance program that benefits low-income individuals. Federal, state and local tax funds are used to assist individuals who are eligible with paying for their medical bills. Usually, Medi-Cal recipients are not required to pay for covered medical expenses, except for a small co-payment.
One way that Medi-Cal is different from Medicare is that it is run by state and local governments, but within federal guidelines. That means that the requirements and benefits of Medi-Cal programs varies from state to state. Eligibility requirements for Medi-Cal may also differ from one state to another. However, most states offer coverage for adults with children living below a certain income level, pregnant women, seniors and individuals with disabilities.
An important note: The Affordable Health Care Act will expand eligibility for Medi-Cal in 2014. So, if you were told last year that you did not qualify, you may qualify now under the new healthcare law.
Applying for Medi-Cal in California.
California’s Medi-Cal program is called Medi-Cal and it offers free or low-cost health coverage for California residents who meet certain eligibility requirements. Beginning January 1, 2014, California will expand Medi-Cal eligibility for low-income adults. The Medi-Cal program offers 21 different health plans for managed care. The options may vary depending on your county of residence. California’s State-based Marketplace is called “Covered California.”
What is Medicare?
Medicare is a federal health insurance program that is available to individuals age 65 and older, disabled individuals and dialysis patients. Eligibility for Medicare is not based on income. With this program, patients only pay a portion of medical expenses through deductibles. Also, small monthly premiums are necessary for non-hospital coverage.
Medicare is different from Medi-Cal in that benefits are provided by private companies through contracts with Medicare. Since Medicare is solely run by the federal government, eligibility and benefits are the same all around the country.
Medicare is divided into two main types of coverage. Medicare Part A is essentially insurance coverage for care in hospitals, skilled nursing facilities, home health care and hospice care. Medicare Part B is medical insurance, which covers doctor visits, outpatient hospital care and other medical services. Usually, individuals are not required to pay for Medicare Part A.
Who is eligible for Medicare?
In addition to being age 65 or older and a U.S. citizen or permanent resident, either you or your spouse must have worked for at least 10 years as a Medicare-covered job. Also, if you are younger than 65, but have a disability or End-Stage Renal disease which requires dialysis or kidney transplant, you may also qualify for Medicare. If you need more information about eligibility and benefits, you can visit www.Medicare.gov.