Learning Center
Plans & pricing Sign in
Sign Out

A Look at the Differences Between Medi-Cal and Medicare


Medicare and Medi-Cal are both government health insurance programs; however, there are some significant differences between them.

More Info
									    A LOOK AT THE
Medicare and Medi-Cal are Both Government
 Health Insurance Programs; However, there
are Some Significant Differences Between Them

                 ROY W. LITHERLAND
                       Elder care attorneys assist people who are planning ahead for the
                       eventualities of aging. When you are engaged in this type of
                       planning, you should understand a bit about Medicare and Medi-

                       Medicare and Medi-Cal are both government health insurance
                       programs. However, there are some significant differences between
      ●   ●   ●        them. Let's take a look at these differences.

Medi-Cal (Medicaid     Need-Based?
  for the State of     Medi-Cal is a program that is available to people who have significant
                       financial need. You cannot qualify for the program if your countable
  California) is a
                       assets exceed $2,000.
  program that is
                       When you are considering the possibility of becoming eligible for
available to people    Medi-Cal, the qualifier “countable” is operative here. Many of the
                       things that you own do not count when Medi-Cal is evaluating your
who have significant
                       eligibility status.
financial need. You
                       Your home is not considered to be a countable asset. Jewelry, such as
 cannot qualify for    family heirlooms and wedding and engagement rings, would not
                       count. Household items and personal effects are not considered to be
the program if your
                       countable by Medi-Cal.
  countable assets
                       Medicare on the other hand is not a need-based program. When you
  exceed $2,000.       are paying taxes throughout your life, a portion of what you pay is
                       going toward the Medicare program. If your overall contributions
      ●   ●   ●        meet the requirements, you become eligible for Medicare coverage
                       when you reach the age of eligibility.

                       Even if you are a billionaire, you can still qualify for Medicare.

                       Eligibility Age

                       Another difference between Medicare and Medi-Cal would be age
                       requirements. There is no particular age requirement if you are
                       seeking Medi-Cal assistance. It is all about financial need.
                          Medicare is a program that is specifically designed to provide health
                          insurance to senior citizens. At the current time, the age of Medicare
                          eligibility is 65.

                          As you are planning ahead for retirement you should recognize the
       ●     ●      ●     fact that the age of Medicare eligibility is subject to change.
                          Lawmakers have consistently floated the idea of raising the eligibility
    Medicare is a         age.
  program that is
                          This is due to the fact that people are looking for ways to reduce the
specifically designed
                          federal deficit. If the age of Medicare eligibility was raised, a
  to provide health       significant amount of money would be saved.
 insurance to senior
   citizens. At the       Long-Term Care

current time the age      From an elder law perspective, the biggest difference between

of Medicare eligibility   Medi-Cal and Medicare is long-term care coverage. Medicare will
                          pay for up to 100 days of convalescent care after surgery. The
           is 65.
                          program will not pay for custodial care. In other words, Medicare will
       ●     ●      ●
                          not pay for an extended stay in a nursing home or assisted living

                          Medi-Cal will assist with long-term care costs if you can qualify for
                          the program. This is why Medi-Cal is relevant to senior citizens who
                          are eligible for Medicare coverage.

                          It is not easy for the ordinary American to pay for long-term care
                          out-of-pocket. In the state of California the average annual charge
                          for nursing home care exceeds $100,000 according to the 2012
                          MetLife Mature Market Institute survey.

                          The average length of stay is right around two years and three
                          months. Ten percent of nursing home residents remain in the
                          facilities for at least five years.

FREE ELDER LAW REPORT                      When you look at these annual surveys, you find that long-term care
                                           costs have been rising by a few percentage points each year. As a
                                           result, if you are a middle-aged individual preparing for the future your
                                           long-term care costs may be considerably higher than they are today.

                                           How likely is it that you will actually need long-term care eventually?
                                           The answer is that it is more likely than not. Most people will need
                                           assistance with their activities of daily living at some point in time.

                                           Medi-Cal Planning

                                           Even though there are low upper asset limits, it is possible to qualify
                                           for Medi-Cal while retaining a significant store of assets for the well-
Protect Your Assets and Preserve Your
                                           being of your family members. The key is to plan ahead well in
    Legacy With a Medicaid Plan
                                           advance, because there is a look back period.
   Learn How to Plan for Medicaid
                                           If you give away assess just prior to applying for Medi-Cal you are
    Download Your Free                     penalized. The exact duration of the look back period has traditionally
      Report Today                         been 30 months in the state of California. The federal look back period
                                           is five years. California is going to convert to the five-year look back
 Medicaid (Medi-Cal in California) is a
   government funded program that          period in the near future.
provide financial assistance for seniors
 that need help paying for healthcare      Conclusion
    services such as a nursing home.
  People must meet certain criteria in     To summarize, Medi-Cal is a need-based program, and Medicare is
  order to receive Medicaid. In some
                                           not. Medicare is specifically designed for senior citizens, but Medi-Cal
   cases, trying to meet eligibility for
                                           is available to people of all ages.
    Medicaid can leave a person with
nothing, often having to deplete their
net worth, or give assets away in order    Medicare will not pay for long-term care, but Medi-Cal will assist with
   to qualify for Medicaid. But with a     these expenses. This is why Medi-Cal planning is important for many
 little Medicaid Planning, you can use     senior citizens.
    this government benefit and still
           retain your estate.
                                            The Medi-Cal rules and regulations are rather complex, and they are
                                            always subject to change. The best way to proceed when you are
      ROY W. LITHERLAND                     interested in obtaining Medi-Cal eligibility would be to retain the
                                            services of a licensed California elder care attorney.

                                            Your lawyer will ask you a series of relevant questions, and he or she will
                                            evaluate your financial situation. Ultimately, you and your attorney will
                                            craft a plan that leads to Medi-Cal eligibility while allowing your family
                                            to retain a maximum store of financial resources.
Roy Litherland has been providing legal
services in Santa Clara and Santa Cruz
Counties continuously since 1975.

Roy has an undergraduate degree in
accounting from Indiana State University,
and a Juris Doctor degree from Indiana
University, where he graduated cum laude
and won honors in the areas of income
taxation and estate and gift taxation. In
law school he was a recipient of the Dean
Faust Award and received awards and
honors in income taxation and estate and
gift taxation.

Roy is certified as a Legal Specialist in
Estate Planning, Trust and Probate Law by
the California State Bar Board of Legal

3425 S. Bascom Ave, Suite 240
Campbell, CA 95008
Phone: (408) 356-9200

To top