Medicare Blog

what is medical vs medicare

by Rico Glover DDS Published 3 years ago Updated 1 year ago
image

Medicare provides health coverage to individuals 65 and older or those with a severe disability regardless of income, whereas Medi-Cal (California's state-run and funded Medicaid program) provides health coverage to those families with very low income, as well as pregnant women and the blind, among others.Jan 25, 2017

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...

What Is Medicare?

Medicare was signed into law by President Johnson in 1965 as a federal health insurance program designed to assist Americans over the age of 65 pay for their medical costs.

What Is Medi-Cal?

Medi-Cal provides health coverage to low-income individuals and families for free or at significantly lower cost than those plans offered through Covered California.

Contact Canopy Health to Learn More

At Canopy Health, we pride ourselves on advocating for the health and wellness of the entire Bay Area, regardless of an individual’s age, health status, or income. Please contact us today at 888-8-CANOPY to learn more about our healthcare network and insurance offerings.

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.

What is medical insurance in California?

Medical is actually Medi-Cal, or in other words a social insurance program initiated by the State of California. It is funded by the state as well as the federal government. This health insurance program looks after the needs of low income group families as it focuses upon people over 65 years of age, pregnant women, poor families and foster care families. The program provides health care benefits to disabled, especially the blind and those who suffer from diseases such as tuberculosis, AIDS, or breast cancer. There are people in California who qualify for assistance under both Medicare, as well as Medical. In some instances, assistance under Medical is used to pay premiums of Medicare.

Does California have medicare?

There are people in California who qualify for assistance under both Medicare, as well as Medical. In some instances, assistance under Medical is used to pay premiums of Medicare.

Do seniors need medical insurance?

If you are a senior citizen or have old parents to take care , it is advisable to have a medical insurance policy to remain prepared for the high expenses that are incurred during hospitalization and treatment of diseases.

Is medical care expensive?

Medical care and assistance has become very costly in the last few years, necessitating having a financial cover, at least in the old age. While most people know about Medicare as an insurance program funded by the federal government that takes care of hospitalization and medical services, not many are aware of a similar program called Medical.

How does private health insurance work?

Copays for services rendered and/or coinsurance are also highly likely. With all of these payments, the health insurance company will pay for you and their enrollees when they are sick. Typically, those with health insurance are relatively healthy and will not undergo significant costs but the way health insurance companies work is that the money is gathered and distributed amongst those that need it at that specific time. The bulk of the money goes to the smaller percentage of individuals who do undergo cost-heavy treatments.

Is Medicare a private insurance?

For many seniors, a combination of Medicare and private insurance provides them with the most comprehensive coverage at the most affordable rate. Medicare is known to have many gaps in their coverage and if you are not aware of these gaps, out-of-pocket expenses can be quick to add up. However, there is one privatized insurance plan that is approved for sale by the government that can provide this combination for optimal coverage and costs.

Is Medicare a government program?

As mentioned, Medicare is a government health insurance program that provides hospital coverage (Medicare Part A), outpatient services (Medicare Part B) and prescription drug coverage (Medicare Part D). It is important to realize that Medicare is not a health insurance company in itself. It is a government program that contracts private healthcare providers to offer medical services to seniors (and qualifying individuals under the age of 65) for an affordable rate. And if you choose Medicare Advantage, you’ll be paying a Medicare-approved private health insurance company who follows the guidelines set by Medicare in order to obtain your benefits.

What is Medicare insurance?

Medicare. Medicare is an insurance program. Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income; and serves younger disabled people and dialysis patients. Patients pay part of costs through deductibles for hospital and other costs.

Do you pay for medical expenses on medicaid?

Patients usually pay no part of costs for covered medical expenses. A small co-payment is sometimes required. Medicaid is a federal-state program. It varies from state to state. It is run by state and local governments within federal guidelines.

Is Medicare a federal program?

Small monthly premiums are required for non-hospital coverage. Medicare is a federal program. It is basically the same everywhere in the United States and is run by the Centers for Medicare & Medicaid Services, an agency of the federal government.

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 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 long does it take to get Medi-Cal?

Processing your application can take several weeks because Medi-Cal must first determine eligibility by verifying your income and personal assets before coverage can be approved. You may request Medi-Cal to pay retroactively for the three months prior to the month in which you apply. back to top.

image
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 1 2 3 4 5 6 7 8 9