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Medicare vs. Medi-Cal: What’s the Difference?
Medicare and Medi-Cal are government-run health insurance programs designed to serve specific populations in different ways.
Roberta Pescow is a contributing writer specializing in health, home improvement, food, personal finance and lifestyle. Her articles have been syndicated on over 200 websites nationwide.
Holly Carey is a managing editor at NerdWallet. She leads the Health Insurance team and supports other insurance topics including life, auto and homeowners. She joined NerdWallet in 2021 as an editor focused on expanding content to additional topics within personal finance. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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Medicare and Medi-Cal are government-run health insurance programs, but each is designed to serve specific populations:
Medicare is federal health insurance for those 65 or older as well as younger people who have end-stage renal disease or certain disabilities.
Medi-Cal is California's Medicaid plan. It's a state-federal program designed to serve people whose income and resources are limited, regardless of their age or health status.
What’s covered under each program?
Medicare
Medicare includes a wide range of health services, but the specific coverage you receive depends on which Medicare plans you sign up for, according to Medicare.gov:
Medicare Part A is Original Medicare’s hospital insurance and is offered through the federal government.
Medicare Part Bis Original Medicare’s medical insurance and is offered through the federal government. It pays for doctor and other health care provider services, outpatient care, some preventive services and durable medical equipment.
Medicare Advantage (also known as Medicare Part C) is a bundled alternative to Original Medicare. Offered through Medicare-approved private insurance companies, it provides hospital and medical coverage as well as, in most cases, prescription drug coverage. Medicare Advantage plans must offer at least as much as Original Medicare, and sometimes these plans come with additional benefits.
Medicare Part D is Medicare’s prescription drug insurance offered through Medicare-approved private insurance companies.
Medigap is supplemental insurance designed to reduce your out-of-pocket expenses while on Original Medicare. Depending on the plan you choose, it may help pay for certain copays or coinsurance, deductibles, excess charges and other expenses that Medicare doesn’t cover.
Shopping for Medicare plans? We have you covered.
Medicare Advantage is an alternative to traditional Medicare offered by private health insurers. It covers the same benefits as Medicare Part A and Part B.
UnitedHealthcare
4.11
CMS Star Rating
Average Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
Humana
3.79
CMS Star Rating
Average Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed.
Medi-Cal offers comprehensive health services and supplies through its choice of over 20 managed health plans, including:
Outpatient visits to a doctor, including checkups.
Emergency care.
Preventive and wellness care.
Hospitalization.
Prescription medications.
Maternity and newborn care.
Laboratory services, including blood tests.
Management of chronic conditions.
Mental health services.
Substance abuse services.
Pediatric services, including vision and oral care.
Physical therapy and other rehabilitative supplies and services.
In-home care.
Transportation services.
Dental care.
Housing assistance.
Meal assistance.
What do Medicare and Medi-Cal cost?
Medicare
Medicare costs depend on which part you’re enrolled in, according to Medicare.gov:
Medicare Part A: Usually has a $0 premium, but it has a $1,736 deductible per benefit period (which begins the day you enter the hospital or skilled nursing facility and ends the day you have been out for 60 days in a row) as well as copayments that start after 60 hospitalized days.
Medicare Part B: Has a minimum premium of $202.90 per month in 2026, a deductible of $283 in 2026, and, for most services, 20% coinsurance.
Medicare Advantage: The average cost for a Medicare Advantage plan is $14 per month in 2026, but costs vary depending on the plan and insurer you choose.
Medicare Part D: The average cost for a Medicare Part D plan is $34.50 in 2026, but costs vary depending on the plan and insurer you choose.
Medigap: Costs vary depending on the plan type and insurer you choose.
Medi-Cal
Monthly premiums for Medi-Cal were eliminated on July 1, 2022. All Medi-Cal monthly premiums are set to $0 for most people, although eligibility is based on your income. Many people who qualify for Medi-Cal can also use its benefits for free, with no copayments or other out-of-pocket expenses.
Who’s eligible for each program?
Medicare
To be eligible for all Medicare plan types, you need to be either:
65 or older.
Younger than 65 and disabled.
Suffering from end-stage kidney disease.
Noncitizens may be eligible for Medicare Part A if they are:
Legal permanent U.S. residents, 65 or older who have worked in the country for at least 10 years in jobs where they (or their spouses) paid Medicare payroll taxes.
Legal permanent residents and certain other immigrants 65 or older with no work history who have lived in the country legally for at least five years.
Legal permanent U.S. residents who are disabled, younger than 65 and meet the same Social Security Disability Insurance requirements as U.S. citizens.
Medi-Cal
Medi-Cal is available to California residents based on certain income requirements, and you can also qualify if you're:
65 or older.
Younger than 21.
Pregnant.
Blind.
Disabled.
Living in a skilled-nursing or intermediate-care facility.
On refugee status.
The parent or caretaker of an eligible child.
Diagnosed with cervical and/or breast cancer.
If you’re enrolled in CalFresh, Supplemental Security Income/State Supplementary Payment (or SSI/SSP), CalWorks, Refugee Assistance, Foster Care or the Adoption Assistance Program, you’re eligible as well.
Children may sometimes qualify for Medi-Cal even if their parents don’t, and adult members of the same household may not always have the same eligibility.
Can I enroll in Medicare and Medi-Cal together?
If you’re 65 or older or are younger than 65 and have certain disabilities — and you live in California — you may be eligible to enroll in Medicare and Medi-Cal if your income qualifies. Medi-Cal may even pay your Medicare premiums when you’re enrolled in both programs.
When you’re covered by both programs, your Medicare plan(s) will cover most of your everyday medical services and prescription medications. Then, Medi-Cal would cover certain long-term supportive care that Medicare doesn’t cover such as community-based services and nursing home care.
How do you sign up for Medicare and Medi-Cal?
Medicare
You can sign up for Medicare during your initial enrollment period (when you first become eligible for Medicare), the general enrollment period (Jan. 1 to March 31) or if you qualify for one of Medicare’s special enrollment periods. To enroll in Parts A and B:
Apply by phone with any Social Security office at 800-772-1213.
Apply by phone with the Railroad Retirement Board at 877-772-5772 if you or your spouse was employed by a railroad.
If you apply for Social Security when you become eligible for Medicare (your initial enrollment period), you’ll automatically be enrolled in Medicare Part A and will have the option to enroll in Part B coverage as well.
You can compare and sign up for Medicare Advantage, Medicare Part D and/or Medigap plans in your area by using Medicare’s plan finding tool.
Medi-Cal
You can sign up for Medi-Cal through Covered California at any time; there are no specific enrollment periods. To apply:
Medigap plan types the company generally offers (availability may vary by location). Options include Plans A, B, C, D, F, G, K, L, M and N.
NAIC complaint rate
How often the company’s members file complaints about their policies as compared to the industry average, according to data from the National Association of Insurance Commissioners (NAIC). NerdWallet conducts its data analysis and reaches conclusions independently and without the endorsement of the NAIC.
Premium discounts available
Based on the number and size of a company’s available discounts on monthly premiums, in comparison to other insurance companies.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
We will match you with Medicare companies and offers based on the information you provide us. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.