If you’re trying to understand your health coverage in California, you may have come across both terms and wondered whether they’re actually the same.
Medicaid is a joint federal-state program, and each state administers its own version within federal guidelines. In California, Medicaid is called Medi-Cal. While the two names refer to the same type of health coverage, California sets its own eligibility requirements and offers programs and benefits specific to residents of the state.
This guide explains the relationship between Medi-Cal and Medicaid, who may qualify for Medi-Cal, and more.
Table of Contents
- Is California Medi-Cal Considered Medicaid?
- What Is the Difference Between Medi-Cal and Medicare?
- Can You Have Both Medi-Cal and Medicare? Here’s How They Work Together
- Do You Need To Reapply for Medi-Cal if You Move to California With Medicaid?
- How Do You Know if You Qualify for Medi-Cal?
- How Legacy Navigation Can Help You Navigate Medi-Cal Planning
Is California Medi-Cal Considered Medicaid?
Yes, Medi-Cal is California’s Medicaid program. Medicaid is a joint federal-state program, and California has administered its program under the Medi-Cal name since 1966.
For California residents, the practical takeaway is simple: Medi-Cal and Medicaid are not two separate programs. You don’t apply for Medicaid and then apply again for Medi-Cal. If you’re applying for Medicaid coverage in California, Medi-Cal is the program you’ll use.
Where things get more complicated is determining whether you or a loved one qualifies. Eligibility can depend on factors such as income, assets, age, and the type of care or coverage you need.
At Legacy Navigation, our Certified Medicaid Planners™ help seniors and their families understand Medi-Cal eligibility requirements and navigate the application process. We can review your situation, explain your options, and help you determine the appropriate next steps.
What Is the Difference Between Medi-Cal and Medicare?
Medicare is a federal health program primarily for people age 65 and older, as well as certain people with disabilities. Medi-Cal is California’s Medicaid program, which provides coverage based on financial and other eligibility requirements. The two programs are not interchangeable, although some people qualify for both.
The distinction can be confusing because both programs serve older adults, but they work differently. Medicare eligibility is primarily based on age or disability and, in many cases, a person’s work history. Medi-Cal eligibility can depend on factors such as income, assets, and other circumstances under California’s rules.
This distinction is especially important when you’re planning for long-term care. Medicare generally does not cover ongoing custodial long-term care, while Medi-Cal may help cover certain long-term care services for people who meet its eligibility requirements. Understanding which program applies to your situation can make a significant difference when you’re planning for the care you or a loved one may need.
Can You Have Both Medi-Cal and Medicare? Here’s How They Work Together
Yes. Some people qualify for both Medicare and Medi-Cal. These individuals are sometimes called dual-eligible, meaning they receive coverage through both programs, and the two can work together to cover different healthcare needs.
Medicare generally covers services such as hospital care and doctor visits, while Medi-Cal can provide additional coverage for certain services that Medicare doesn’t cover. Depending on your eligibility and coverage, this may include services such as dental and vision care and certain long-term care services.
Having both programs doesn’t mean you receive two separate sets of benefits for the same service. Instead, Medicare and Medi-Cal coordinate coverage based on the type of care you need and the rules that apply to your situation. For older adults and people with disabilities who may need ongoing care, understanding how the two programs work together can be an important part of planning for future healthcare and long-term care needs.
Do You Need To Reapply for Medi-Cal if You Move to California With Medicaid?
Yes. Medicaid coverage does not transfer between states. If you move to California from another state, you’ll need to submit a new application for Medi-Cal, even if you were already approved for Medicaid where you previously lived.
It doesn’t matter which state you’re moving from or how long you were covered there. California requires a new application, which will be evaluated under its own income, asset, and eligibility rules. This can catch families off guard, especially when they’re already managing the stress of relocating an aging parent for care.
Because you’ll need to establish coverage in your new state, it’s important to plan for the transition rather than waiting until after the move. If you’re coordinating a parent’s move to California, planning ahead can help you address the healthcare and coverage details alongside the other considerations involved in moving an elderly parent to another state.
The team at Legacy Navigation can also help you navigate the Medi-Cal application process and understand the requirements that apply to your situation.
How Do You Know if You Qualify for Medi-Cal?
Eligibility comes down to the income and asset limits set by California, but those numbers may be different than what other states use for their Medicaid programs. Your eligibility may also depend on other factors, so simply living in California doesn’t automatically mean you qualify for Medi-Cal.
A full eligibility review may look at several aspects, including:
- Income and assets
- Life insurance policies
- Veteran status
- Your home and whether it may be protected from a Medicaid lien
Because the rules can be complicated and vary depending on your circumstances, a Medicaid eligibility calculator can be a helpful starting point. The calculator walks you through many of the questions Medicaid uses to evaluate eligibility, then provides a worksheet indicating whether you may qualify or whether you should speak with a Medicaid planner for a more detailed assessment.
Keep in mind that the calculator is only a starting point. The income and asset limits, as well as the programs and options available to you, depend on the state and your individual circumstances. If you’re unsure where you stand, getting guidance before applying can help you understand your options and avoid making assumptions about your eligibility.
How Legacy Navigation Can Help You Navigate Medi-Cal Planning
Understanding that Medicaid is the same as Medi-Cal in California is a good first step, but navigating eligibility and long-term care planning can be more complicated. At Legacy Navigation, our Certified Medicaid Planners™ take a comprehensive approach to Medicaid planning, bringing together the medical, psychosocial, and financial aspects of your situation. Our Clinical Care Team includes a Registered Nurse and Master Social Worker, and our team has more than 40 years of combined experience in the healthcare industry.
Our services include:
- Medicaid planning for both early and crisis planning
- Holistic senior care planning
- Medicaid application assistance, including acting as your Authorized Representative through the application process
- Medicaid financial planning and asset protection
- Clinical case management
- Resources and assistance for seniors during times of uncertainty
Whether you’re just beginning to explore Medi-Cal or need help navigating an application and planning for long-term care, you don’t have to figure it out alone. Contact Legacy Navigation to request a consultation and learn how our team can help you understand your options and take the next step.
