What is the difference between Medi-Cal and Medicare in California?
Asked by: Hermina Sawayn PhD | Last update: October 2, 2023Score: 4.9/5 (14 votes)
Medi-Cal is California's Medicaid health care program. Medi-Cal pays for a variety of medical services for children and adults with limited income and resources. Medicare is a federally funded insurance program for eligible participants 65 or over.
Can a person 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.
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 happens to my Medi-Cal when I turn 65?
If you qualify for Supplemental Security Income (SSI), you automatically qualify for full Medi-Cal coverage. To qualify for SSI, you must be age 65 or older, blind or disabled.
Is Medi Medi the same as Medicare?
Medicaid is a joint federal and state program that helps pay medical costs if you have limited income and resources and meet other requirements. Some people qualify for both Medicare and Medicaid and are called “dual eligible.” This is also referred to as “Medi-Medi.”
Difference Between Medicare and Medicaid and Medi-Cal?
Is Medi-Cal full coverage?
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.
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 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.
What are the benefits of Medi-Cal for seniors?
Medi- Cal provides many of the state's poorest seniors with vital health insurance coverage, including wrap- around coverage for medical services Medicare does not cover. It also provides a safety net for seniors re- quiring long-term care who have exhausted their own financial resources.
What is the highest income for Medi-Cal?
- You are 19-64 years old and your family's income is at or below 138% of the Federal Poverty Level (FPL) ($20,120 for an individual; $41,400 for a family of four).
- You are a child 18 or younger and your family's income is at or below 266% of FPL ($79,800 per year for a family of four).
Is Medicare free in California?
Medicare Part A is usually free if you or your spouse paid Medicare payroll taxes for approximately ten years while working (this is called “premium-free Part A”). If you don't qualify for premium-free Part A, you may have the option to pay for hospital insurance, also called “premium Part A”.
Does Medi-Cal cover surgery?
medications. Inpatient hospital services • Anesthesiologist services • Surgical services (bariatric, reconstructive surgery, etc.) Organ & tissue transplantation • Outpatient laboratory and X-ray services o Various advanced imaging procedures are covered based on medical necessity.
Does Medi-Cal have premiums?
How much are the premiums? 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.
Does Medi-Cal pay for Medicare Part B premium?
The State of California participates in a buy-in agreement with the Centers for Medicare and Medicaid Services (CMS), whereby Medi-Cal automatically pays Medicare Part B premiums for all Medi-Cal beneficiaries who have Medicare Part B entitlement as reported by Social Security Administration (SSA).
Does Social Security retirement count as income 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. Gifts, royalties, and inheritances also count as unearned income.
Does Medi-Cal cover people over 65?
Medi-Cal is a government program that pays for health and medical care for seniors 65 and over or disabled persons who have low incomes and limited resources.
How much can I make and still get 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. You can qualify for Medi-Cal even if you have assets.
Does Medi-Cal expire every year?
Local Medi-Cal offices review each member's eligibility once a year or when they report changes to their household. Everyone's renewal date is different.
Who is eligible for Medi-Cal seniors?
Basic Information Beginning May 1, 2022, a new law in California will give full scope Medi-Cal to adults 50 years of age or older and immigration status does not matter. All other Medi-Cal eligibility rules, including income limits, will still apply.
What changes to Medi-Cal 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. Medi-Cal managed care enrollment does NOT affect a beneficiary's Medicare providers or Medicare Advantage plan.
Is Blue Cross the same as Medi-Cal?
Medi-Cal Managed Care (Medi-Cal)
are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County.
Will I lose my Medi-Cal if I get a job?
If you get Medi-Cal coverage and then get a job, you have a couple of options for keeping your Medi-Cal benefits. If you got Supplemental Security Income (SSI) cash benefits before you got your job, Social Security's 1619(b) program lets you earn up to $56,758 annually and still keep Medi-Cal coverage at no cost.