What's the Difference Between Medicare and Medi-Cal?
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At Bella Vista Health Center, many people who call to inquire about our services also want to know what kind of insurance we accept. When we mention Medicare and Medi-Cal, the callers often ask, “What’s that?” or “What’s the difference between Medicare and Medi-Cal?”
Both are really good questions.
Below, you’ll find bullet-point descriptions of Medicare and Medi-Cal, what they cover, and who qualifies. We hope you find them helpful.
Medicare
What it is:
- A federal health insurance program
Who qualifies:
- Ages 65+
- Younger people with disabilities
What it covers:
- Hospital bills
- Post-hospital nursing home stays
- Home health care
- Medical insurance
- Basic doctor and lab costs
- Some out-patient medical services and equipment
- Physical therapy
- Some prescription costs
- Limited time in a skilled nursing facility (with conditions and restrictions)
Administered by:
- Centers for Medicare and Medicaid Services (CMS)
Identification card colors:
- Red, white, and blue
To check your eligibility for Medicare, go to your local Social Security office or call the Social Security Administration at 800-772-1213.
Medi-Cal
What it is:
- A state health care program
Who qualifies:
- Families and individuals with low income or limited resources
- People who receive:
- Supplemental Security Income (SSI)
- CalWORKS
- Refugee or foster care assistance
- Others:
- Age 65+
- Blind
- Disabled
- Pregnant
- Under 21
- Parent of someone under 21
- Nursing home resident
- People who receive:
What it covers:
- Outpatient (ambulatory) services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance abuse disorders (including behavioral health treatment)
- Prescription drugs
- Rehabilitative and habilitative services (PT and OT) and devices
- Laboratory services
- Children’s services (including oral and vision care)
- Dental services
- Vision services
Administered by:
- California Department of Health Care Services
Identification card colors:
- Red and white
San Diego County residents can begin the online application process at www.mybenefitscalwin.org. To request a mail-in application, call 866-262-9881. Or stop by one of the San Diego County social services facilities listed here: [http://www.sandiegocounty.gov/content/sdc/hhsa/programs/ssp/medi-cal_program/how_to_apply.html]
Note: Many people do qualify for both Medicare and Medi-Cal.
You matter to us.
At Bella Vista Health Center, we understand how frustrating it can be to navigate the world of health insurance while you’re recovering or rehabilitating yourself. If you have any questions for us about which of our services your insurance covers, please don’t hesitate to ask. Give us a call or drop by our Lemon Grove location. We’ll help you in any way we can.
