Medicare Versus Medi-Cal

Medicare and Medi-Cal (called Medicaid in other states) are two different government programs which provide healthcare benefits. It is important to understand the difference between them.
Medicare is a program administered by the federal government to provide healthcare to certain populations, including those 65 and over. Premiums are paid typically by monthly social security deduction. There is “Original Medicare” which is divided into Parts A (hospital/homehealth/hospice) and B (doctors visits, etc). Original Medicare does not cover prescription drug coverage; however, you can enroll in Medicare Part D through a private insurance company with paid premiums. A person can also “assign” their Medicare to an “Advantage Plan” – which is like an HMO. Medicare Advantage plans provide Medicare benefits through a private-sector health insurer. The choices for providers will be more limited, and the coverage would be through that insurer.
Medi-Cal is much different. Eligibility for Medi-Cal is needs-based. Elder law attorneys typically assist clients who require expensive Skilled Nursing Facilities (over $10,000.00 per month) to obtain Medi-Cal benefits, so that the care costs are substantially reduced or eliminated for the client.
Only Medi-Cal will cover long-term care expenses for Skilled Nursing Facilities. (Medicare typically only provides for “up to 100 days” of Skilled Nursing Care, and the full 100 days is very difficult to obtain). California Medi-Cal rules are unique, and much different than any other state. There are numerous legal strategies that can be used to protect assets while getting needed care, since Medi-Cal is a needs-based program. If long-term Skilled Nursing care is needed, or you would like to be proactive and protect assets in advance, then an elder law attorney can help explain the legal strategies available to you.
For an appointment, please call the McNamara Law Firm at (661) 287-3260 or visit www.theMcNamaraLawFirm.com.