What is the difference between Medi-Cal and Medicaid?
Asked by: Dr. Norene Dickinson Sr. | Last update: October 19, 2023Score: 4.3/5 (26 votes)
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.
How does Medi-Cal differ from Medicaid?
Medi-Cal and Medicaid are essentially the same thing. Medi-Cal is designed to pay medical costs for low-income persons of any age. Medi-Cal is a need-based program, meaning it is available to those who, regardless of age, meet the state's financial eligibility and medical qualification requirements.
Is California Medicaid the same as Medi-Cal?
Medi-Cal is California's Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes.
Can you have Medi-Cal and Medicaid?
It is possible for members of the same family to qualify for both Medi-Cal and Covered California. This is because the Medi-Cal eligibility rules are different for children and adults. Most people who apply for Medi-Cal can find out if they qualify based on their income.
What is the highest income to qualify for Medicaid?
Federal Poverty Level thresholds to qualify for Medicaid
The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. In 2023 these limits are: $14,580 for a single adult person, $30,000 for a family of four and $50,560 for a family of eight.
Difference Between Medicare and Medicaid and Medi-Cal?
What is the minimum income to qualify for Medi-Cal in California?
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.
What does the Medi-Cal cover?
Medi-Cal covers primary care, specialty care, prescription drugs, and dental if it is considered "medically necessary." Most people who have Medi-Cal do not pay co-pays or out-of-pocket costs.
What income does Medi-Cal count?
Income-based Medi-Cal counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based Medi-Cal eligibility.
Who gets Medicaid in California?
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.
Is Kaiser Permanente California Medicaid?
Kaiser Permanente participates in Medi-Cal in many counties. This means that if you are a current Kaiser Permanente member and your situation changes, you may be able to keep your same doctor and continue your care with Kaiser Permanente if you qualify for Medi-Cal.
Can you have Medicare and Medi-Cal at the same time?
Some people qualify for both Medicare and Medi-Cal and are “dual eligible” or Medi Medi beneficiaries. When an individual has both Medicare Parts A and B, Medicare is the primary insurance and pays for most medical care.
What are the 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 count as health insurance?
Medi-Cal is health coverage, just like the coverage offered through Covered California. Medi-Cal provides benefits similar to the coverage options available through Covered California, but often at lower or no cost to you or your family.
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.
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.
Who funds Medi-Cal in California?
Medi‑Cal provides health care coverage to over 14 million Californians with low incomes. As a joint state‑federal program, costs are shared between the federal and state as well as local governments.
Does Medi-Cal look at your savings account?
Medi-Cal limits seniors and people with disabilities to assets of no more than $2,000 for individuals and $3,000 for couples — a restriction that has not changed since 1989. Assets include cash on hand, money in a checking or savings account, a second car, and other resources.
Does Medi-Cal check your assets?
4. How to Qualify. To find out if you qualify for one of Medi-Cal's programs, look at your countable asset levels. As of July 1, 2022, you may have up to $130,000 in assets as an individual, up to $195,000 in assets as a couple, and an additional $65,000 for each family member.
Can I have a savings account and still qualify for Medi-Cal?
For example: A Medi-Cal applicant whose total non-exempt property consists of a savings account with a balance of $3,300 in a month must reduce the savings account to $2,000 in that month. In this same situation, where there is a couple, the savings must be reduced to $3,000.
What age does Medi-Cal stop?
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.
Does Social Security income count for Medi-Cal?
Unearned Income
This type of income relates to interest on savings and retirement accounts, pensions, annuities, veteran's benefits, etc. Social Security counts as unearned income as well.
What is California Medi-Cal changing to in 2023?
Starting January 2023, Medi-Cal health coverage for most remaining dually eligible beneficiaries changed from Fee-For-Service (FFS) Medi-Cal to Medi-Cal Managed Care.
Do you have to apply for Medi-Cal every year?
Medi-Cal members must renew their coverage each year to keep their health care benefits. For most members, coverage is renewed automatically. Sometimes the county will send you a renewal form that you must review and return, along with any additional required information.