Do You Understand Medi-Cal?
When elders in California need medical care, they have many options open to them. One of the options – Medi-Cal – is a California-specific program. The law is complex, and to understand where you stand and how to utilize this program, you would want to speak with a skilled attorney.
At my firm, The Law Office of Philip M. Flanigan, P.C., I have provided clients with insight into Medi-Cal and other elder care issues for over 30 years. I help people throughout California navigate the complexities of elder care planning. My first goal is to educate you on Medi-Cal and then help you make the right decisions for your future.
The Difference Between Medi-Cal And Medicare
Medicare and Medi-Cal are both health providers, but they have significant differences. The major difference is that they are funded in very different ways. Medicare, of course, is a federal program, while Medi-Cal receives both state and federal funding. There are many other differences between the programs, for instance:
- Medicare: Provides medical coverage at either no cost or shared cost to older individuals and those with severe disabilities.
- Medi-Cal: Provides significantly reduced cost, or free medical care to low-income families, people with disabilities or certain refugee statuses.
Understanding how Medi-Cal will interact with your estate plan and elder care plans is often confusing. I guide my clients through the process, and I provide them with the confidence to know they’ve made the right decisions for their future.
Answering Your Questions On Medi-Cal
Obviously, one important aspect of having confidence in the choices you make is having full, complete answers to all your questions. In most cases, your personal situation will be unique and require personalized answers. However, below I have put together the answers to some general questions that can help you figure out what you need to know.
Who is eligible for each program?
We mentioned briefly above some of the general groups covered in each program. More specifically, you are eligible for Medicare if you are over 65, disabled or have end-stage renal disease.
For Medi-Cal, the eligibility is somewhat wider:
- Any household making under 138% of the poverty line
- Any person who is blind
- A person with a disability
- People under 21
- Pregnant people
- Those in a nursing facility
- A parent of an eligible child
- Anyone screened for breast or cervical cancer
Additionally, individuals enrolled in certain programs also have some eligibility. The program seeks to help the most vulnerable people receive the health coverage they need.
Can assets and savings disqualify you from receiving benefits?
Previously, your assets and savings may have impacted your ability to receive benefits. However, after the affordable care act passed, that has gone away. If you meet the eligibility requirements, your assets should have no impact for community Medi-Cal.
What is “Share of Cost,” and how to plan for it?
“Share of cost” means paying for a portion of the medical care. Typically under traditional private insurance, a shared cost includes co-pays for doctors’ visits and prescriptions. Under Medi-Cal, there are some shared costs. However, the goal is to keep those to a minimum.
You can plan for the possible shared costs of your plans. You should have this discussion with your attorney, and you can devise a personalized plan to settle these needs.
Will I be able to keep my current health care team under Medi-Cal or Medicare?
Both programs have large numbers of doctors and hospitals under them. Many health care providers accept these coverages, but not all. Your attorney can help you review your coverage, plan, and doctor’s plans.