Is Medi-Cal better than Medicaid?

Asked by: Prof. Coy Purdy  |  Last update: August 13, 2023
Score: 4.2/5 (21 votes)

Medi-Cal is what we call the joint Federal-State Medicaid program in California (just like Covered California is what we call Obamacare in California). Medi-Cal and Medicaid are essentially the same thing.

Is there a difference between Medi-Cal and Medicaid?

Medi-Cal is California's Medicaid program. Medicaid is partly funded by the federal government and partly by the state. In California, Medi-Cal provides unified health insurance benefits that cover all necessary medical expenses up to the program's limits.

What is the downside of Medi-Cal?

There is a fundamental problem with Medi-Cal that is hindering patient access to care, and to specialists in particular – Medi-Cal physician reimbursement is so low that physicians cannot cover the cost of providing care.

What are the pros of Medi-Cal?

What You Get
  • Preventive Care. Enjoy free services, like well-baby visits and checkups.
  • Emergency Services. Ambulance and emergency room services.
  • Primary Care. Doctor visits for sickness, injuries or other concerns.
  • Dental and Vision. ...
  • Family Planning. ...
  • Prescription Coverage. ...
  • Mental Health and Substance Use Disorder.

Is Medi-Cal a good program?

The health plans offered by Covered California and Medi-Cal include the same full set of benefits, but Medi-Cal is usually at lower or no cost. You can preview plans and benefits here. In a recent survey of Medi-Cal members, 90% of the members who answered rated Medi-Cal as a good or very good program.

Difference Between Medicare and Medicaid and Medi-Cal?

44 related questions found

Does Medi-Cal pay for everything?

Medi-Cal covers most medically necessary care. This includes doctor and dentist appointments, prescription drugs, vision care, family planning, mental health care, and drug or alcohol treatment. Medi-Cal also covers transportation to these services. Read more in “Covered Benefits” on page 12.

Is Medi-Cal really free?

For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. Effective July 1, 2022, all monthly premiums were reduced to $0.00.​ In general, individuals in Medi-Cal will get the same health benefits available through Covered California at a lower cost.

Who needs Medi-Cal?

You can also get Medi-Cal if you are:
  • 65 or older.
  • Blind.
  • Disabled.
  • Under 21.
  • Pregnant.
  • In a skilled nursing or intermediate care home.
  • On refugee status for a limited time, depending how long you have been in the United States.
  • A parent or caretaker relative of an age eligible child.

What type of insurance is Medi-Cal considered?

Medi-Cal, California's Medicaid program, is a public insurance health care program which provides health care services for low-income individuals and families who meet defined eligibility requirements.

How much income is too much for Medi-Cal?

Most single individuals will qualify for Medi-Cal if there income is under $1,676 per month. Most couples will qualify if their income is under $2,267 per month. If you have disabilities, your income can be slightly higher. You can qualify for Medi-Cal even if you have assets.

Does Medi-Cal pay Medi-Cal bills?

If you meet the requirements of the program, Medi-Cal will help pay for doctor visits, hospital stays, prescription drugs, rehabilitation, and other medical services.

What are the disadvantages of Medicaid?

Disadvantages of Medicaid
  • Lower reimbursements and reduced revenue. Every medical practice needs to make a profit to stay in business, but medical practices that have a large Medicaid patient base tend to be less profitable. ...
  • Administrative overhead. ...
  • Extensive patient base. ...
  • Medicaid can help get new practices established.

Does Medi-Cal cover more than Medicare?

Medi-Cal also provides additional benefits beyond what's usually included with Medicare Parts A and B, covering prescription drugs, dental, vision care, extended stays in skilled nursing facilities and long-term care in nursing homes.

Does Medi-Cal cover braces?

Does Medi-Cal or Denti-Cal Cover Braces? Yes. But, not everyone with Medi-Cal/Denti-Cal qualifies for these benefits. A patient must first be evaluated to rate the degree of the malocclusion, which is a problem in the way the upper and lower teeth fit together in biting or chewing, such as an overbite or under bite.

What is the new name for Medi-Cal?

On January 1, 2023, Cal MediConnect plans transitioned to Medicare Medi-Cal plans (MMPs or Medi-Medi plans) provided by the same companies that provided Cal MediConnect plans.

What is another name for Medi-Cal?

The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal ...

Can I go to any hospital with Medi-Cal?

Emergency Rooms: As stated above, if you have an emergency and you cannot find a doctor right away, you can go to the emergency room at any hospital. If you show your BIC to staff at the emergency room, Medi-Cal will pay for the services you receive.

Can anyone qualify for Medi-Cal?

Medi-Cal gives people with low incomes access to health services, including medical and dental care. The program is available for adults, children, pregnant women, older adults and people with disabilities. People who have certain conditions, such as tuberculosis and HIV, might also qualify for Medi-Cal.

What age does Medi-Cal cover?

All California residents under the age of 26 who meet the eligibility requirements can qualify to receive Medi-Cal, regardless of U.S. citizenship or immigration status. Receiving Medi-Cal will not make you a public charge.

Is Medi-Cal for poor families?

This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources.

How much is Medi-Cal monthly?

Medi-Cal monthly premium amounts have been reduced to $0.00 effective July 1, 2022. Monthly billing and collection of premiums for the Medi-Cal for Families program will no longer be required.

Do you have to pay back Medi-Cal in California?

Do you have to pay back California Medicaid? The Medi-Cal program is required to seek repayment from the estates of certain deceased Medi-Cal members. The rules state that repayment only applies to the benefits received by members on or after their 55th birthday and who owned assets at the time of death.