If you have an elderly loved one who is living on a fixed income, and also has regular monthly medical expenses, those expenses may be adding up quickly. If your loved one is lucky enough to have private healthcare coverage, then he or she is better off than many elderly Americans. Unfortunately, many of America’s elderly struggle with both the rising cost of healthcare and the increased need for medical services as a result of the natural aging process. Two government programs–Medicaid (called Medi-Cal in California) and Medicare– are potentially available to help with those costs.
Although there are a number of differences between the Medicaid (Medi-Cal) and Medicare programs, understanding the more important differences will help you get a better idea if either program might be able to assist your loved one.
Both programs are federally funded; however, Medicaid (Medi-Cal) is administered by the states which means that there may be slightly different eligibility criteria and benefits among the states. Medicare requires a monthly participation payment for some of its coverage. Medicaid (Medi-Cal) does not require the payment of any premiums or participation fees, but co-payments may be required for specific services.
Medicaid (Medi-Cal) is income and asset based whereas anyone over the age of 65 (and some disabled individuals under 65) may participate in Medicare. Medicaid (Medi-Cal) covers more services than the Medicare program, but getting approved is more difficult due to the strict income and asset eligibility guidelines. If your loved one has income or assets that you are concerned may prevent approval for the Medicaid program, there may be alternatives. Talk to your estate planning attorney about ways to structure his or her estate that will fit into the income and asset guidelines.
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