Medicare vs Medi-Cal: Understanding The Differences & Making The Right Choice

AirTalk Wireless | Jan 14, 2025

1. What are Medi-Cal and Medicare?

Medicare

Medicare is a federal health insurance program directly managed by the Centers for Medicare & Medicaid Services (CMS). A key feature of Medicare is its standardized coverage across all states in the United States, thanks to uniform regulations on costs and benefits set by the program.

When enrolled in Medicare, your healthcare-related expenses are covered by two trust funds overseen by the U.S. Department of the Treasury. Participants are only required to pay a portion of the costs, including monthly premiums, deductibles, coinsurance, and prescription drug expenses.

👉 Explore more details about Medicare at Medicare.gov

Medi-Cal

Medi-Cal is a health insurance assistance program in the state of California, considered one of the most important initiatives for its residents. With the mission of providing high-quality medical services and healthcare at a low cost or even for free, Medi-Cal particularly targets people with low incomes or those in difficult circumstances.

This program not only expands access to top-notch medical services and improves health quality but also alleviates the financial burden for families with limited resources.

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2. The Difference Between Medicare and Medi-Cal

Although Medicare vs medical shares the common goal of helping individuals access medical and healthcare benefits, the two programs differ significantly in terms of eligible participants, coverage, and cost-sharing. To help you make an informed decision, AirTalk Wireless has prepared a detailed comparison chart highlighting the key differences between Medical and Medicare.

	Medicare	MediCal
Eligible participants	– People aged 65 and older. – People under the age of 65 with disabilities or specific medical conditions are also eligible for this program.	– Seniors aged 65 and older, especially those with limited income. – Low-income individuals and households. – Pregnant women with low incomes are eligible for the program. – People with disabilities. – Children in foster care. – Refugees and asylum seekers if they meet income and residency requirements. – People enrolled in other assistance programs: SSI, SNAP or CalWORKs, etc.
Coverage	Medicare is divided into 4 parts: – Part A (Hospital Insurance): Covers hospitalization, healthcare costs, and some other medical services. – Part B (Medical Insurance): Covers expenses for doctor visits, lab tests, and other medical services not included in Part A. – Part C (Medicare Advantage): This is an additional insurance plan offered by private companies. Medicare Advantage combines the benefits of Part A and Part B, while also offering additional services such as prescription drug coverage, dental, and vision care. – Part D (Prescription Drug Coverage): Provides insurance for prescription medications, helping to offset the costs of medications for beneficiaries.	Medi-Cal offers a wide range of services, such as: – Ambulatory patient services. – Emergency services. – Hospitalization. – Maternity and newborn care. – Dental (Denti-Cal) and vision care. – Long-term care and support, etc.
Cost-sharing	– Part A: Typically, there is no monthly premium for individuals who have paid sufficient Medicare taxes during their working years. Otherwise, a monthly premium may apply. – Part B: Requires a fixed monthly premium, which is adjusted annually. Additionally, there may be copayments and coinsurance for the services provided. – Parts C and D: Monthly premiums vary depending on the provider and specific plan. In addition, copayments and coinsurance may apply to the services and medications covered.	The MedicCal Program provides medical and health care services completely free of charge to beneficiaries. However, some individuals may be required to pay small co-payments for certain services. The program aims to minimize financial barriers to help low-income individuals and households access necessary health care

3. What to Know About the Combination of Medicare and Medi-Cal

From the information provided above, you have certainly grasped the benefits offered by the Medicare and Medi-Cal programs. However, combining both programs can provide participants with additional advantages as follows:

Dual eligibility

The beneficiary mentioned here refers to a person who is eligible to participate in both programs, Medicare and Medi-Cal. To be eligible, participants must meet criteria related to age, disability status, and income level.

Enrolling in both programs not only significantly reduce their medical and healthcare costs but also expands the combined coverage of both programs – a substantial benefit that everyone will appreciate.

How the two programs coordinate

When an individual is a dual beneficiary, Medicare typically pays first for medical services covered by this program.

Subsequently, Medi-Cal covers the remaining balance, including co-pays, coinsurance, and other expenses not covered by Medicare. This coordination helps alleviate the financial burden on enrollees and ensures they receive necessary healthcare services without excessive concern about costs.

medical vs medicare — Medicare and Medi-Cal can be combined.

What is the state of California benefits identification card used for?

BIC stands for Benefits Identification Card, which is a card provided to beneficiaries when participating in the Medi-Cal program. It serves as proof of eligibility for Medi-Cal services and is used to access a wide range of health care benefits, including doctor visits, hospital services, prescription medications, and other necessary medical treatments.

The BIC is essential for verifying eligibility and ensuring that beneficiaries receive the health care services they are entitled to under the Medi-Cal program.

The difference between Medicare vs Medicaid vs Medi-Cal

Medicare is a health insurance program for seniors, people with disabilities, or those with specific medical conditions.
Medicaid is a joint federal and state program that helps cover medical costs for individuals with low income and limited assets.
Medi-Cal is the name of the Medicaid program in California.

It is important to have a basic understanding of the differences between Medicare vs Medicaid vs Medi-Cal to avoid confusion when searching for and choosing the program that best suits your needs and circumstances.

medical vs medicaid vs medicare — How to differentiate MediCal vs Medicaid vs Medicare.

Understanding the differences between Medicare vs Medi-Cal is important for making the right decision about your healthcare coverage.

While Medicare offers federal coverage for seniors and those with disabilities, Medi-Cal is California’s Medicaid program aimed at helping low-income individuals and families.

If you’re eligible for both, the combination of Medicare and Medi-Cal can significantly reduce your healthcare costs.

>>> Don’t miss: Top Senior Benefits In California You Shouldn’t Miss