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What’s The Difference Between Medi-Cal and Medicaid Insurance?

Smiling Hispanic man shaking doctors hand in hospital and illustrating what is the difference between MediCal and Medicaid.

Shopping for health insurance to obtain coverage by a certain date can be intimidating and overwhelming at the same time. Especially with the federal mandate of the Affordable Care Act that states you face a penalty for not having health insurance. And, for those individuals who can least afford coverage, it can be even more confusing as they try to figure out the difference between Medi-Cal and Medicaid insurance.

Actually, the good news is – there is no difference between the two. Medi-Cal health insurance is merely California’s Medicaid program, which is paid for with federal and state tax revenues. It’s the easiest way for low-income California residents, who meet certain requirements, to enroll in a health insurance plan for themselves and their families, despite limited financial means. If your income is within the Medi-Cal limits for your family size, you’ll be eligible to receive Medi-Cal coverage at no cost or low-cost to you.

What is covered by Medi-Cal?

Medi-Cal is more or less like any of the other health plans you can purchase on the Covered California exchange; in that Medi-Cal insurance contains the same 10 comprehensive services known as “essential health benefits” as designated by the Affordable Care Act to include:

  • Outpatient (ambulatory) services (Doctor visits)
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Programs such as physical and occupational therapy (known as rehabilitative and habilitative services) and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Children’s services, including immunization, oral and vision care.

While an immigrant who meets all other eligibility requirements, but doesn’t possess a satisfactory immigration status is not eligible for full scope Medi-Cal, he or she may still be entitled to receive emergency, pregnancy-related services, and state-funded long-term care, when needed.

For those with lawful residency, keep in mind there are income limits to qualify for no-cost Medi-Cal health insurance. Eligibility is based on your family’s net monthly income after allowances for child care and working expenses. In other words, your income minus these expenses must be at or below the limit specified for the size of your family.

Medical Dental and Vision Coverage

In addition to standard health coverage as required under the Affordable Care Act, Medi-Cal also offers dental and vision plans for qualifying adults and children. Orthodontic care may or may not be covered by the dental plan, depending on the degree of the corrective procedure needed to repair the malocclusion. To learn more about dental benefits and eligibility, you can contact your nearest Freeway Insurance agent or visit Denti-Cal.

Vision benefits are also available for those with full-scope Medi-Cal benefits. All Medi-Cal members are eligible for a routine eye exam once every 24 months, at which time they can check the health of their eyes as well as test to see if an eyeglass prescription may be needed.

Unlike open enrollment for private health plans through Covered California, which runs from November 1, 2015 through January 31, 2016 – enrollment for Medi-Cal is open year-round.

So, even if your financial situation limits you to free insurance or low-cost coverage, you can still take advantage of the 10 essential health benefits, along with the other Medi-Cal benefits available. Health insurance for undocumented immigrants may also be possible after meeting certain eligibility requirements, although benefits may be on a more limited scale.

To simplify the process of searching for health coverage – Freeway Insurance, the premier healthcare insurance broker, has partnered with Covered California, along with some of the nation’s most trusted carriers to help provide their customers with the best health quotes and make obtaining low-cost or no-cost health insurance as easy as possible. Plus – Freeway’s services are absolutely 100% free.

Why not get started today and choose from the different types of health insurance to find the one that’s right for you? Freeway Insurance can offer you an assortment of affordable health plans. Call (800) 777-5620 to speak with an agent to get a free health insurance quote or you can get your free health insurance quote online!

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