Medicare and Medi-Cal: How They Differ and What You Need to Know
Be honest: As you get older, are you ready for all the changes to your medical care?
Many people don’t know the difference between Medicare and Medicaid (or Medi-Cal in California), which is understandable. After all, the details about our health insurance are often quite complicated. If you’re not careful, you might be missing some crucial information about these government programs right when you need it the most.
However, this guide will answer all your key questions and explain everything you need to know about Medicare, Medicaid and Medi-Cal differences. Ready to safeguard your health and protect your future? Keep reading to learn everything you might be wondering about these three health insurance programs.
Decoding the Health Coverage Puzzle
What is the difference between Medicare and Medicaid or Medi-Cal? In short, Medicare is designed to provide medical coverage to those with disabilities and those who are at least 65 years old. It is not income based. Meanwhile, Medicaid and Medi-Cal programs are designed for those who may not have other healthcare options due to financial hardship.
A good way to remember Medicare and Medicaid differences is that only the latter program has any kind of income requirement. As for Medicare, it is available to anyone who is 65 or older, making it a cornerstone of healthcare for elderly people throughout America. In California, understanding how to choose the right California health plan will help maximize protection.
If you are confused about how open enrollment for health insurance in California might affect your healthcare, keep in mind that Medicare and Medicaid or Medi-Cal do not follow Open Enrollment dates. Medicare enrollment is based on when you turn 65, while Medicaid and Medi-Cal are available to apply for all year.
Medicare Explained
One of the biggest differences between Medicare and Medicaid is the coverage scope and cost of these different health insurance programs. For example, Medicare is broken into four parts, with Part A covering hospitalization. Part B covers medically necessary care and equipment, though individuals who make at least $103,000 per year will pay more for this program.
Part C offers additional coverage (like dental, hearing, and vision) through private companies. Finally, Part D covers prescription medicine costs. Keep in mind this program has monthly premiums, a deductible, and select copayments, and you may not be able to get both Part C and Part D at the same time.
The exact costs of these four parts may vary. Part A is generally free for most people but has a $1,632 deductible for the first 60 days of a hospital stay, with additional costs accruing beyond that. Part B currently has a premium of $174.70 and a deductible of $240, after which you pay 20 percent of the coinsurance costs. The exact costs of Part C and D vary by plan.
Medicaid and Medi-Cal Demystified
All states have Medicaid, and most states support what is known as expanded Medicaid, which provides coverage for anyone making less than 133% of the federal poverty level. There are a few states that don’t offer expanded coverage, including Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. California has its own named program in Medi-Cal.
As a program, Medicaid is relatively robust, offering services for hospital stays, nursing homes, family planning, and much more. If you live in California and you are worried about money, there are a variety of ways to get low-cost or free health insurance in California.
The best thing about this program is that those who qualify for it don’t have to pay any out-of-pocket costs. At age 65, participants will also qualify for Medicare.
Navigating Dual Enrollment
While there are some major differences between the programs, it’s possible to qualify for both because everyone 65 or older qualifies for Medicare. If you meet the income requirements for Medicaid, you can benefit from both programs at the same time.
For those who qualify for both programs, the state will take care of Medicare Part B premiums and provide additional assistance for prescription drug costs. Additionally, your state may pay for more of the costs associated with the plan, including coinsurance, copayments, and deductibles. Whenever it comes to overlapping coverage, Medicare will pay out before Medicaid does.
Staying Informed and Prepared
You can apply for Medicare through the Social Security website. You can also apply for Medicaid directly through its website and for Medi-Cal through its website.
Each of these sites also provides contact info for professionals who can answer additional questions. Between their answers and this guide, the application process should be smooth and hassle-free.
Get the Most Affordable California Health Insurance Today
Now you know the most important differences between Medicare and Medicaid or Medi-Cal, including what the eligibility requirements are. You know how to apply and potentially start saving big on your medical needs. But do you know who can take your savings even further?
Here at Cost-U-Less, we offer the affordable and reliable health insurance you’ve been looking for. Ready to take control of your future by taking control of your medical coverage? Then it’s time to give us a call at 866-951-0476 for a free consultation.
FAQs
Still have questions? Below, you will find answers to the most common questions about these major health programs.
What Is the Main Difference Between Medicare and Medicaid?
The main difference is that Medicare has an age restriction (65 or over unless you have a qualifying disability), and Medicaid has an income restriction.
How Do I Know If I’m Eligible for Both Medicare and Medicaid?
Most people qualify for Medicare simply by turning 65. After that, you can apply for Medicaid through its official website to verify that you qualify.
