You should consult an attorney for advice regarding your individual situation.

Medi-Cal: An Overview Anyone who begins looking into long-term care options will quickly run into the terms Medicare and Medi-Cal.

Many people confuse Medi-Cal and Medicare, but they are two different programs and unrelated.

In todays post, I will do my best to give you a basic overview of the two programs.

Medicare is a federal program that provides basic health insurance for everyone over age 65, and people under age 65 who are eligible for Social Security Disability benefits.

Medicare is not based on financial need; anyone who meets the age, disability, andor coverage requirements is eligible.

Participants in the Medicare program are liable for premium payments, deductibles and co-payments.

Medicare has several parts: Medicare Part A is Hospital Insurance Medicare Part B is Medical Insurance Medicare Part C (Medicare Advantage) is private insurance plans Medicare Part D is Prescription Drug coverage Medicare does not pay for long-term care.

After a three-day hospital stay resulting from an illness or surgery, it will pay 100 percent of skilled nursing care, but only for the first 20 days.

After 100 days of skilled nursing care, Medicare stops paying altogether.

Medi-Cal is designed to pay medical costs for low-income persons of any age.

Medi-Cal is a need-based program, meaning it is available to those who, regardless of age, meet the states financial eligibility and medical qualification requirements.

Medi-Cal is a main source of financing for skilled nursing and long-term care in California.

Medi-Cal will cover most, if not all, of the cost of a skilled nursing facility, but only if a physician deems the care as medically necessary.

In addition to skilled nursing costs, Medi-Cal covers what are called essential health care services, including doctor visits, hospital care, immunizations, some dental services, ambulance services, prescription drugs, lab tests, and some types of in-home care.

Medi-Cal Eligibility To qualify for Medi-Cal, a person must be 65 or older or receiving Social Security Disability Insurance and have countable assets of 2,000 or less (or 120,000 if married).

Meeting the states financial assets requirement is the most challenging aspect of Medi-Cal eligibility.

In one of my other post, I will cover how Medi-Cal looks at your income and assets, explain terms like spend down and look back, and discuss how I can help you or your parents qualify for Medi-Cal.

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