No, “Medical” and Medicare are not the same thing. If you live in California, “Medical” almost certainly refers to Medi-Cal, the state’s version of Medicaid. People often pronounce it as “medical,” which creates confusion with Medicare. These are two completely separate health insurance programs with different eligibility rules, different funding sources, and different benefits. Medicare is a federal program primarily for people 65 and older. Medi-Cal (Medicaid) is a state and federal program for people with limited income, regardless of age.
How Medicare and Medi-Cal Differ
Medicare is run entirely by the federal government through the Centers for Medicare & Medicaid Services. It’s funded by payroll taxes and congressional appropriations held in two U.S. Treasury trust funds. Your age and work history determine whether you qualify, not your income.
Medi-Cal is California’s name for Medicaid, a joint federal and state program. The federal government sets baseline rules, but California runs its own version. Funding comes from both state and federal dollars, and eligibility is based almost entirely on income. Every state has its own Medicaid program with a different name. In California, it’s Medi-Cal. In New York, it’s Medicaid. In Oregon, it’s the Oregon Health Plan. If you’re outside California and heard the term “medical,” you may be thinking of Medicaid in general.
Who Qualifies for Medicare
Medicare covers three groups of people. The largest group is anyone 65 or older who has paid into Social Security through payroll taxes during their working years. You don’t need to have low income. Wealthy retirees and low-income retirees both qualify at 65.
The second group is people under 65 with disabilities. If you receive Social Security Disability Insurance, you become eligible for Medicare after a 24-month waiting period from when your disability benefits begin. The third group is people with end-stage kidney failure requiring dialysis or a transplant, who can qualify at any age.
Who Qualifies for Medi-Cal
Medi-Cal eligibility is based on household income relative to the federal poverty level. For most adults, the income limit is 138% of the federal poverty level. In 2025, that means a single person earning up to $21,597 per year can qualify, while a family of four can earn up to $44,367. Each additional family member raises the limit by about $7,590.
There is no age requirement. Children, working-age adults, pregnant women, seniors, and people with disabilities can all qualify if their income falls within the limits. California has also expanded Medi-Cal to cover undocumented immigrants at all income-eligible levels, making it one of the broadest Medicaid programs in the country.
What Each Program Covers
Medicare covers hospital stays, doctor visits, lab tests, and outpatient procedures. It does not cover most dental care, routine vision exams, or hearing aids under the original program (though some Medicare Advantage plans add these). Long-term nursing home care is a major gap: Medicare only pays for skilled nursing facility stays up to 100 days, and only after a qualifying three-day hospital stay. It does not cover custodial care, which is the ongoing help with daily activities that most nursing home residents need.
Medi-Cal covers a broader range of services in some important ways. It includes adult dental care through the Medi-Cal Dental Program, vision services, and long-term custodial care in nursing facilities. Two-thirds of California’s nursing home residents rely on Medi-Cal to pay for their care. Medi-Cal also covers In-Home Supportive Services, which pays for help with bathing, grooming, bowel and bladder care, and household chores so people can stay in their homes rather than move to a facility. It even offers an Assisted Living Waiver in select counties.
Medicare provides stronger coverage for short-term medical needs like surgeries, specialist visits, and rehabilitation. Medi-Cal fills in the gaps that Medicare leaves, particularly around long-term care, dental, and vision.
What Each Program Costs You
Medicare is not free for most services. In 2025, the standard monthly premium for Medicare Part B (which covers doctor visits and outpatient care) is $185, with an annual deductible of $257. Part A (hospital coverage) is premium-free for most people who paid payroll taxes for at least 10 years, but it still has deductibles and copays for hospital stays. Many people buy supplemental insurance or enroll in Medicare Advantage plans to reduce their out-of-pocket costs.
Medi-Cal has little to no cost for enrollees. Most members pay no premiums, no deductibles, and minimal or zero copays. This is one of the biggest practical differences between the two programs.
You Can Have Both at the Same Time
Some people qualify for both Medicare and Medi-Cal simultaneously. This happens most often with low-income seniors who are 65 or older and also meet Medi-Cal’s income requirements. These individuals are called “dual eligibles,” and having both programs can be a significant advantage.
For dual eligibles, Medicare acts as the primary insurance, covering hospital stays and doctor visits. Medi-Cal then steps in as secondary coverage, often paying Medicare premiums and copays that the person would otherwise owe out of pocket. Medi-Cal also adds benefits that Medicare lacks, like dental care, vision, and long-term custodial care. As of 2026, California requires that a dual-eligible person’s Medi-Cal managed care plan align with their Medicare Advantage plan choice when an affiliated plan exists, making it easier to coordinate care across both programs.
How to Apply for Medi-Cal
If you think you qualify for Medi-Cal based on your income, California offers four ways to apply. You can go online through BenefitsCal (the state benefits portal) or through Covered California (the state health insurance marketplace, which will route you to Medi-Cal if you qualify). You can also call your local county office, visit one in person, or download a paper application and mail it in. If you apply through Covered California and your income is too high for Medi-Cal, you’ll be shown subsidized private health plans instead.
Medicare enrollment, by contrast, is handled through the Social Security Administration. Most people are enrolled automatically when they turn 65 if they’re already receiving Social Security benefits. If not, you sign up during your Initial Enrollment Period, which starts three months before your 65th birthday.