Medicaid, Medi-Cal, And Medicare: Explaining Their Important Differences

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Government funding is channeled into programs to help the needy, disabled, and elderly. As you look for a nursing home for your elderly parent, you may become confused by the names assigned to these programs. You may hear Medicaid, Medicare, and Medi-Cal, and wonder which program fits your aging parent's needs. Here is an expanded definition and explanation of these programs so that you can help your parent choose the best ones for his/her needs.

Medi-Cal

Unless you actually live in California, Medi-Cal would be irrelevant to you and your parent. If you plan to move yourself and your parent to California in the future, then Medi-Cal may become relevant to you at that time. The short answer here is that Medi-Cal is California's Medicaid program. Their state government just thought it would be "cuter" to call it Medi-Cal (Medicaid California medical insurance; hence, Medi-Cal). It provides most of the same medical and health insurance benefits as other state Medicaid insurance programs.

There are some slight differences, but none more unusual than any other state. Their medical billing and coding system is also a little different. Other than that, if you ever become a resident of the state of California, the income standards and guidelines for applying and receiving insurance through this program are very similar to other states.

Medicaid

Medicaid is what every other state in the Union besides California calls the low-income, state-sponsored health insurance. The name is a mish-mosh of "medic-(al)" and "aid" to get Medicaid. You can look up the state and county guidelines where you live to see if your parent qualifies for the program. Low income, disability, and specific age requirements must be met to apply. If your parent does not have complete control over mental faculties, you may apply on behalf of your parent.

Medicaid covers all major medical, surgical, and maintenance health care. If your parent needs a specialist that does not work for the healthcare network of your parent's other doctors, Medicaid covers the costs of a referral and seeing that out-of-network specialist. There are dental and vision benefits too, but what they provide differs from state to state.

Medicare

Medicare is the program sponsored by the federal government for the disabled and retirees who have reached the required age. There are several sections to Medicare, all of which should be read thoroughly before your parent selects a program and signs on the line. Otherwise, moving him/her to a nursing home may not work out as planned because the Medicare plan he/she chose initially may not be accepted by the home to which you want to move your parent.

Medicare changes may only be made annually, usually on the date of enrollment or your parent's birthday. You will have to find out which of those two date options applies to your parent. In the meantime, he or she may have to stay put, or stay with you, until that annual change date rolls around.

Still Confused? Talk to a Medicaid Specialist

You would not be the only adult child caring for an elderly parent that gets completely confused and lost in regards to the aforementioned healthcare options. That is what Medicaid (or Medi-Cal) experts are there for. If you need something else sorted out for you, or you have more questions about these programs, Medicaid experts can help. You can also visit a site like http://www.seniorsolutionsofli.com.

You can also try calling your local DHS (Department of Human Services). However, caseworkers and social workers frequently have an overloaded case schedule and rarely answer their phones during business hours unless you are already a client. For that reason, you will get your answers faster if you just talk to a Medicaid specialist.

25 September 2017