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Home arrow Resources arrow Articles arrow What is Medicaid?

What is Medicaid?

Medicaid is a medical care resource to serve low-income adults and children across the United States.

While Medicaid is a federal program, it has distinct variations between states. The Medicaid program for the state of California is known as Medi-Cal. The purpose of Medi-Cal is to provide medical services of all types for lower-income adults and children. Medi-Cal may also provide different types of family benefits, such as food and childcare supplies, for those who need it. The Medi-Cal program in California is supported by federal as well as state taxpayers.

Who Qualifies for Medicaid?

In California, you must meet the following requirements to qualify for the Medi-Cal program.

-United States citizen, United States national, United States permanent resident, or a legal alien to the United States.

-Resident of the state of California

-Low income

-Meet at least one of the following criteria: Over age 65, pregnant, blind, disabled, have a family member living with you with disability, or have children under 19 years old.

If each of these requirements is met, you may complete a Medi-Cal application for benefits. The application process typically takes around 45 days if you are applying primarily based on low income, and around 90 days if you are applying based upon a physical disability. The longer time for approval of Medi-Cal coverage with a disability reflects the fact that case workers must coordinate with doctors, hospitals, or any other medical personnel who have treated you or monitored your medical condition in the past.

Medicare and Specific Diseases

Medicare accepts into its program people who are suffering from serious illnesses and diseases, including tuberculosis, breast cancer, or HIV/AIDS. Although the existence of one of these diseases is not enough to get a person accepted into Medicare, any person with a lower income bracket who is suffering from one of these diseases has a good chance to quality. In many cases, even those who have private insurance policies may exhaust their policy or have insufficient insurance through their provider, because claims became so high. Medicare will often step in with cases like this to help low-income individuals make sure that they get the care they need.

Costs of Medicaid

In most cases, Medicaid participants will not be required to pay anything for their Medi-Cal services in California, because the majority of participants are living at the poverty level and can't afford to contribute any money towards their health care costs.

However, people who qualify for Medi-Cal and have higher incomes will be required to pay a certain portion of their medical expenses. A Medi-Cal participant who has more income than the limits designated for their family size will pay a "Share of Costs." The Share of Costs is calculated on a monthly basis, and it works like a deductible. For example, a Medi-Cal patient may have a Share of Costs amount of $100. In any month where that person used Medi-Cal services, he or she will pay the Share of Costs first, and then the program will pay the remainder of the costs.

Medicare and Other Insurances

Medicare is simply not enough in many cases. While it does cover many medical situations, there are a number of times that some type of supplemental coverage will be a wise choice for program participants. Speak with us today about the combination plan that can protect you and your loved ones the most effectively!

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