The Differences Between Health Insurance Programs
Medicare and Medi-Cal are two health insurance programs that differ in crucial ways. The first program is not tied to individual needs but is a government entitlement paid for by FICA taxes. Medicaid was created in response to the escalating costs of medical care for older citizens and is also funded by FICA taxes. Both programs have different eligibility requirements but are often awarded to the same person if they meet the appropriate conditions.
Medicare
As an American citizen, you’re probably aware of the differences between Medicare and Medi-Cal. Both programs provide health care coverage to Americans, low-income Californians, and people with disabilities. However, Medicare and Medi-Cal are not mutually exclusive. In California, 1.6 million people qualify for both programs. To be eligible for both, you must meet specific criteria. For example, to qualify for Medicare, you must be at least 65 years of age and have a low income.
Depending on your county, Medi-Cal California Medicaid plans may pay for all or part of the services you need. However, Medi-Cal does have rules about what it will cover. For example, it only pays for accepted drugs and may require prior authorization for some services. For these reasons, it’s essential to research your Medi-Cal plan before determining what services it covers. Fortunately, many Medi-Cal plans are flexible and easy to understand. T
Social Security
To obtain Medicare coverage, you must first apply for it. The process is relatively simple. You need to provide your Social Security number, proof of citizenship, and your current address, and wait at least three months before you start to receive benefits. In some states, individuals may be eligible for benefits as early as three months after they turn 65. If you meet all of these requirements, you can sign up online for Medicare.
In addition to Medicare, SSI recipients may also qualify for a program called SNAP, which helps people buy food. SNAP is also offered in several states and can be applied at a local social security office. In addition to Medicare, these programs provide money for other medical expenses, such as prescription medication and dental care. However, Medicaid is not a substitute for traditional Medicare or private health insurance.
California Working Disabled program
How these two insurance programs work is a big difference between Medicare and Medi-Cal. In California, the state’s 250% Working Disabled Program offers a zero-share-of-cost health plan to people who work at least one hour a month with pay. To qualify, you must meet specific eligibility requirements and pay a monthly premium to the Department of Health and Human Services. Once enrolled, Medi-Cal pays for all covered medical services.
Medicare and Medi-Cal are federal health insurance programs covering medical costs for low-income beneficiaries. They provide coverage for inpatient and outpatient care, doctor visits, preventive care, and medical testing. But you must meet specific income requirements to qualify for Medicare, which is also available in other states. Meanwhile, a joint state-federal health insurance program is designed to meet California’s low-income residents’ needs. It covers prescription drugs but generally excludes long-term care and extended stays in skilled nursing facilities.
Income limits
The limits on income for Medicare, Medicaid, and Medi-Cal are based on countable assets. For example, a person with an income of $130,000 and a couple with an income of $195,000 may qualify for Medi-Cal. This is not the case with SSI, where the asset limit is $2,000 for individuals and $3,000 for couples. There are several ways to determine if you qualify for Medi-Cal benefits.
If you’re disabled, your income will not count against your Medi-Cal eligibility. For example, if you’re single and disabled and earning under $47,000 per year, you might be eligible for a lower income limit. However, if you’re married and have children, your income will count against you. Depending on your situation, the income limit for Medicaid and Medicare differs. For example, single disabled individuals may qualify for a lower income limit than married couples. If you’re unsure if you qualify for Medi-Cal, you can ask your benefits planner for help.
Share of cost
California’s Share of Cost system requires Medi-Cal recipients to pay a portion of their monthly medical costs. Medi-Cal covers the rest. A person’s share of cost equals their maintenance need standard, less their net monthly income. People who make more than the median income have a higher cost percentage.
The Share of Costs between Medicare, Medicaid, and Medi-Cal programs varies from state to state, but Medi-Cal generally pays for medically necessary services. Medi-Cal covers prescription drugs, most dental services, and home health care. However, Medicare pays the monthly Part B premium and deductibles, and Medi-Cal covers only the remaining amount. The benefits you receive from Medi-Cal depend on your county.
