Medi-Cal and Medicare

Medi-Cal

  Is a program in California that helps people with low incomes get health care.

 

  A single adult can get Medi-Cal if they make up to $1,562 a month ($18,755 a year), and a married couple can get it if they make up to $2,105 a month ($25,268 a year).

 

  People who sign up for Medi-Cal get full health care, including inpatient and outpatient care, long stays in skilled nursing facilities, and long-term care in nursing homes. These are services that Medicare doesn’t usually pay for. Original Medicare doesn’t cover care for the eyes or teeth, but Medi-Cal does.

 

  People who sign up for Medi-Cal get full health care, including inpatient and outpatient care, long stays in skilled nursing facilities, and long-term care in nursing homes. These are services that Medicare doesn’t usually pay for. Original Medicare doesn’t cover care for the eyes or teeth, but Medi-Cal does.

Eligibility

Medi-Cal is available based on certain income requirements, and you can also qualify if you’re:

– 65 or older.- Younger than 21.- Pregnant.- Blind.- Disabled.- Living in a skilled-nursing or intermediate-care facility.- On refugee status.- The parent or caretaker of an eligible child.- Have been screened for cervical and/or breast cancer.
If you’re 65 or older or are younger than 65 and have certain disabilities — and you live in California — you may be eligible to enroll in Medicare and Medi-Cal if your income qualifies. Medi-Cal may even pay your Medicare premiums when you’re enrolled in both programs.

When you’re covered by both programs, your Medicare plan(s) will cover most of your everyday medical services and prescription medications. Then, Medi-Cal would cover certain long-term supportive care that Medicare doesn’t cover such as community-based services and nursing home care.

How to sign up

You can sign up for Medi-Cal through Covered California at any time; there are no specific enrollment periods. To apply:

– In person: Visit your local county office. You can locate your closest county office: https://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx

– Online: Visit the Covered California website. (https://www.coveredca.com/)

– By mail: Fill out an application online, print it and mail it. You can find instructions: https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SingleStreamApps.aspx

– By phone, fax or email: For instructions, contact your local county office or call Covered California at 800-300-1506.

Medicare

   Meidcare is a national program that helps seniors and people with certain disabilities.

 

    Most people become eligible for Medicare at age 65, without having to meet any income, health status, or residency requirements.

 

     Medicare provides coverage on an individual basis; spouses and other family members are not covered. Unlike Medi-Cal, the coverage can extend to family members within the household.

 

4 parts of Medicare (with distinct area of care)

Part A
Also called Medicare Advantage, gives "all-in-one coverage" that includes Medicare Parts A and B and, usually, coverage for prescription drugs.
Part B
Helps pay for care outside of a hospital, like doctor visits. Beneficiaries must pay a monthly premium of $170.10, and those with higher incomes will pay more. Also, people who get Medicare Part B must pay a $233 deductible before coverage starts.
Part C
Also called Medicare Advantage, gives "all-in-one coverage" that includes Medicare Parts A and B and, usually, coverage for prescription drugs.
Part D
Covers prescription drugs for Medicare recipients who have signed up for Parts A and B but not Medicare Advantage. The average monthly cost is $42.

Eligibility

To be eligible for all Medicare plan types, you need to be either:

– 65 or older.- Younger than 65 and disabled.- Suffering from end-stage kidney disease.

Noncitizens may be eligible for Medicare Part A if they are:

– Legal permanent U.S. residents, 65 or older who have worked in the country for at least 10 years in jobs where they (or their spouses) paid Medicare payroll taxes.

– Immigrants 65 or older with no work history who have lived in the country legally for at least five years.

– Legal permanent U.S. residents who are disabled, younger than 65 and meet the same Social Security Disability Insurance requirements as U.S. citizens.

How to sign up

You can sign up for Medicare only during the initial enrollment period (when you first become eligible for Medicare) or during Medicare’s special enrollment periods. To enroll in Parts A and B:

– Apply online for Medicare: https://secure.ssa.gov/iClaim/rib

– Apply in person at any Social Security office.Apply by phone with any Social Security office at 800-772-1213.

– Apply by phone with the Railroad Retirement Board at 877-772-5772 if you or your spouse was employed by a railroad.

If applying for Social Security when you become eligible for Medicare (your initial enrollment period), you’ll automatically be enrolled in Medicare Part A and will have the option to enroll in Part B coverage as well.

You can compare and sign up for Medicare Advantage, Medicare Part D and/or Medigap plans in your area by using Medicare’s online tool: https://www.medicare.gov/plan-compare/#/?lang=en&year=2022