how do i tell if i have medi cal or medicare

Knowing which kind of Medicaid

you have can be tricky. Every state has its own Medicaid program, which means coverage, requirements, and Medicaid cards will vary. The best way to know which one you have is to call the number on the back of your insurance card.

Full Answer

How do I know if I have Medicare or Medicaid?

Every state has its own Medicaid program, which means coverage, requirements, and Medicaid cards will vary. The best way to know which one you have is to call the number on the back of your insurance card. In some cases, it’s possible for someone to have both Medicare AND Medicaid.

What does a Medicare insurance card look like?

Since Medicare is a national program, all Medicare insurance cards look the same. Here’s an example: People with Medicare Advantage will have two insurance cards: One for traditional Medicare, and one for their Medicare Advantage plan. Medicare Advantage cards will look different from each other, depending on the plan.

How to check your Medicare enrollment status?

How to Check Your Medicare Enrollment Status 1 Check your Medicare enrollment online. ... 2 Review your Medicare plan coverage options. ... 3 Make changes to your Medicare plan coverage during the right time of year. ... 4 Find out what Medicare plan may fit your needs. ...

How do I find out if I qualify for Medi-Cal?

Mybenefitscalwin.org has an online questionnaire you can fill out to quickly determine whether or not you meet the requirements for the program. Find the number of your local social services office. While Medi-Cal is a statewide program, it is administered at the local level.

How do I know if I have Medi-Cal or not?

Call Medi-Cal Directly You can also check on your Medi-Cal status by calling the Medi-Cal hotline at (800) 541-5555. If you're outside of California, call (916) 636-1980.

Is Medi-Cal the same as Medicare?

No. Medicare and Medi-Cal are two separate programs for health care coverage. Medicare is available nationally to cover seniors and people under the age of 65 with certain disabilities. Medi-Cal is California's Medicaid program, covering low-income individuals and families in California.

Can a person have both Medicare and Medi-Cal?

The short answer to whether some seniors may qualify for both Medicare and Medi-Cal (California's Medicaid program) is: yes. Although some people under age 65 qualify for Medicare, such as individuals with end-stage renal disease (ESRD), our focus in this post is on seniors age 65 and older.

How do I check my Medi-Cal status online?

You can access your member services online through your plan's website and the Covered California website. Each service manages different aspects of your coverage. Also, your local county office will take care of specific parts of your Medi-Cal membership.

What are the two types of Medi-Cal?

This guidebook explains the two kinds of Medi-Cal: Regular Medi-Cal and Medi-Cal Health Plans.

What is Medicare called in California?

Medi-CalMedi-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.

Is Medi-Cal free?

Medi-Cal offers free or low-cost health coverage for California residents who meet eligibility requirements. Most applicants who apply through Covered California and enroll in Medi-Cal will receive care through managed health plans.

Who qualifies for Medi Medi?

Medi-Cal covers a wide variety of people, including people who are under 65, living with a disability, as well as children under 19, parents, or other adults caring for a child, and even adults without dependent children in some locations as long as they demonstrate financial need.

What is the max income to qualify for Medi-Cal?

The income limits based on household size are: One person: $17,609. Two people: $23,792. Three people: $​​29,974.

Is Medi-Cal Medicaid?

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.

Does Medi-Cal expire?

Medi-Cal members must renew their coverage each year to keep their health care benefits.

What is the Difference Between Medi-Cal and Medicare?

The primary differences between Medicare and Medi-Cal are the eligibility requirements regarding residency, income and assets.

Is Medi-Cal the same as Medicaid?

Medicaid is a federal and state program that provides a way for low-income people to have healthcare coverage. Each state runs and manages its own...

Can You Have Medi-Cal and Medicare Coverage?

You can be eligible for and have both Medicare and Medi-Cal. This is known as dual eligibility. People who are dual-eligible may be over 65 or have...

I Have Medicare and Medi-Cal How Do They Work Together?

Part A will be free if you have worked and paid Medicare taxes for at least 40 quarters in the United States. Most people don’t pay a monthly premium for Part A, due to work history. If you are not entitled to receive Part A Premiums to see your options.

What Medi-Cal Covers

Medi-Cal will typically cover all or most of your Medicare out-of-pocket costs (e.g. deductibles, copays and coinsurance). You can often expect to pay nothing for most services as long as you have full Medi-Cal with no share-of-cost.

Non-medical Home Health

Original Medicare will not cover any home health services that are not medically necessary. This includes having someone help you with bathing, going to the bathroom, cleaning the house, shopping, or any other service that can fall under assisted living with home health. This would also include any nursing homes or assisted living facilities.

Part D

Original Medicare does not include prescription drug coverage. Some medications may be covered when administered within a doctors office. Outside of the doctors office, any pharmacy filled medications will require a prescription drug plan (PDP) to be purchased from a private company.

Important Note for Medicare and Medi-Cal!

It’s very likely that you are on a managed Medi-Cal plan. Today, approximately 10.8 million Medi-Cal beneficiaries in all 58 California counties receive their healthcare through a managed Medi-Cal plan. You may recognize these as Anthem or Calviva Health Net Medi-Cal.

What is the Difference Between Medi-Cal and Medicare?

The primary differences between Medicare and Medi-Cal are the eligibility requirements regarding residency, income and assets.

Is Medi-Cal the same as Medicaid?

Medicaid is a federal and state program that provides a way for low-income people to have healthcare coverage. Each state runs and manages its own Medicaid program.

Can You Have Medi-Cal and Medicare Coverage?

You can be eligible for and have both Medicare and Medi-Cal. This is known as dual eligibility. People who are dual-eligible may be over 65 or have a disability, plus have an income level that meets the criteria for Medi-Cal.

Sources

Medi-Cal Eligibility and Covered California – Frequently Asked Questions. CA.gov.

APPLYING FOR MEDICARE AND MEDI-CAL

Information about Medi-Cal, resources for applying and eligibility are provided by the Department of Health Care Services.

GENERAL INFORMATION

California Health Advocates offers Medicare advocacy, benefits information, and education for Californians.

FRAUD

The Bureau of Medi-Cal Fraud Elder Abuse explains how to report suspected Medi-Cal fraud or elder abuse to the Department of Justice.

What is Medi-Cal for Medicare?

Medi-Cal (for People with Medicare) Medi-Cal, the Medicaid program in California, provides health coverage to people with low-income and asset levels who meet certain eligibility requirements. While there are several ways to qualify for Medi-Cal, this section focuses only on Medi-Cal beneficiaries who also qualify for Medicare — individuals who are ...

How much does Medi-Cal pay for medical expenses?

Your SOC is determined according to your monthly income, using the following formula: Medi-Cal subtracts $600 (for an individual) or $934 (for a couple) from your monthly income, and any other health-insurance premiums you may be paying.

What is Cal MediConnect?

Cal MediConnect is a demonstration program with the goal of integrating care for people with both Medicare and Medi-Cal. The demonstration is happening in 7 selected counties: Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara, and began on various dates depending on the county.

What is Medicare Part D?

2. Prescription Drugs. If you are receiving both Medicare and Medi-Cal benefits, the Medicare Part D drug benefit will provide your prescription-drug coverage instead of Medi-Cal. You must be enrolled in a Medicare Part D drug plan or a Medicare Advantage prescription drug plan to get these benefits.

How much does Medi-Cal pay for SOC?

For example, if you have an individual monthly income of $1,300, Medi-Cal subtracts $600 for a SOC of $700 . This means you must pay at least $700 in covered medical expenses and/or health care premiums in a given month before Medi-Cal covers any of your health care costs for that month.

Which MA plan works best for people with Medicare and Medi-Cal?

If you choose an MA plan, the MA plan that works best for people with both Medicare and Medi-Cal is the Special Needs Plan (SNP) for dual eligibles or D-SNP. If you’re enrolled in a D-SNP, you do not have copays, coinsurance or premiums associated with other types of MA plans.

How much does a person need to be to qualify for Medi-Cal?

To qualify for SSI, you must be age 65 or older, blind or disabled. Your countable monthly income may not exceed $954.72 for an individual or $1,598.14 for a couple (higher income levels apply for individuals who are blind).

How do I know if I have medicaid?

The best way to know which one you have is to call the number on the back of your insurance card.

What is Medicare Part A?

Parts of Medicare. Part A – Covers time spent in a health facility such as a hospital, hospice care, or home health agency. Part B – Covers health expenses such as doctor visits, surgery, medical supplies, lab work, and test screenings. Part C – A combination of Part A and B that can also include dental, vision, prescriptions, ...

What is QMB in Medicare?

Qualified Medicare Beneficiary Only (QMB) is a Medicaid-funded program that provides financial assistance to cover Medicare Part A and Part B premiums. It also covers Medicare deductibles, coinsurances, and copays.

What is Medicaid in the US?

Medicaid is a health program provided by individual state governments to people who meet at least one of the income or disability requirements. Nobody is automatically enrolled in Medicaid. To receive it, you must apply through your state’s Medicaid office.

What are the two types of medicaid?

There are two basic types of Medicaid: Fee-For-Service and Managed Medicaid. Fee-For-Service – Medicaid pays doctors, hospitals, and other healthcare providers for the individual services or products received by the Medicaid member. Managed Medicaid (Managed Care Plan) – The state contracts with a private insurance company to manage ...

How many parts are there in Medicare?

About Medicare. Medicare is a national health program provided by the US government. It’s divided into 4 parts: Part A, Part B, Part C, and Part D. Every American who paid into Medicare is automatically enrolled in Part A and Part B when they turn 65. People under 65 with certain disabilities may also apply to enroll.

How to find out if you have SLMB+?

Product coverage and plan availability will be different for each state. To find out if you have SLMB+, call the number on the back of your insurance card.

What is an annual review of Medicare?

An annual review of your Medicare coverage can help you determine if your plan combination is right for your needs. For example, if you’re spending a considerable amount of money on prescription drugs, a Medicare Part D plan or a Medicare Advantage plan with prescription drug coverage may be something to consider.

What is Medicare Part B?

Medicare Part B is medical insurance and provides coverage for outpatient appointments and durable medical equipment. Part B is optional, but is required for anyone wanting to enroll in Medicare Part C, Part D or Medicare Supplement Insurance. Part A and Part B are known together as “Original ...

How long does Medicare AEP last?

The Medicare AEP lasts from October 15 to December 7 every year. During this time, Medicare beneficiaries may do any of the following: Change from Original Medicare to a Medicare Advantage plan. Change from Medicare Advantage back to Original Medicare. Switch from one Medicare Advantage plan to another.

What are the benefits of Medicare Advantage?

Most Medicare Advantage plans offer additional benefits not covered by Original Medicare, such as dental, vision and prescription drug coverage. Medicare Part D provides coverage for prescription medications, which is something not typically covered by Original Medicare.

Is Medicare Part A and Part B the same?

Part A and Part B are known together as “Original Medicare.”. Medicare Part C, also known as Medicare Advantage, provides all the same benefits as Medicare Part A and Part B combined into a single plan sold by a private insurance company.

What happens if you don't have a Medi-Cal account?

If you are not active, your case worker can look into the account to let you know the status of the application and whether any additional steps are needed to have the agency either accept or deny the request.

Where can I find Medi-Cal?

While Medi-Cal is a statewide program, it is administered at the local level. A list of the county welfare offices can be found on the DHCS website or in your local phone book under Health and Human Services or Social Services.

How many people are in Medi-Cal?

According to the California Department of Health Care Services (DHCS), one-third of the state's population, which includes over 13.2 million Californians, are registered for Medi-Cal, yet some don't realize their status is active.

Can I get Medi-Cal if I am a citizen?

The Medi-Cal eligibility requirements have expanded, which means individuals and families that previously didn't qualify, may now be approved. If you are a citizen or legal resident of the state of California and you earn less than 138 percent of the Federal Poverty Level, you probably qualify.