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MEDI-CAL AND TRICARE

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Eligiblity for Medi-Cal through SSI is available in case your monthly income doesn’t exceed $856 for an individual or $1,502 for a married couple (figures for April 1, 2007 – March 31, 2008), if you have no more than $2,000 in assets as an individual or $3,000 in assets as a couple. The numbers are reconsidered annually on April 1st. The income limits are higher for people who are blind, being $921 for an individual and $1,729 for a married couple, the assets remaining the same. The eligibility for Medi-Cal is extended through the Aged and Disabled Federal Poverty Level program (A&DFPL).

This group has an opportunity to get prescription drugs and long-term care as well as paying for Medicare premiums, deductibles and cost-sharing. Medi-Cal also provides assistance with Medicare cost-sharing but not drug or long-term care prescription for the small share of low-income Medicare beneficiaries (SLMBs) (Kaiser Commision 2005, CalMedicare. org 2007). Cost-share is also provided for hose individuals who have higher incomes that do not meet the Medi-Cal eligibility requirements, but whose high medical expenses significantly reduce the income.

One is qualified through Medi-Cal’s “medically needy” pathway in case medical bills leave him with less than $600 per month for living expenses as a single person or $934 per month as a married couple, assets being at or below $2,000 for an individual and $3,000 for a couple. Then Medi-Cal pays for an individual’s Part B premiums even in the months he does not incur medical expenses (CalMedicare. org 2007). Medic-Cal also covers immigrants. According to Kaiser Commission on Medicaid and Uninsured, ‘Citizens, lawful permanent residents and certain other immigrants who meet other eligibility requirements may qualify for full Medi-Cal services.

Undocumented immigrants and other immigrants without satisfactory immigration status can qualify for limited Medi-Cal coverage (such as Emergency Medi-Cal which covers prenatal care, long-term care, and certain other services), which are paid for using only state funds’ (Kaiser Commission 2005, p. 2). Now let us move to the TRICARE options. One can choose among three basic types: Tricare Prime, Tricare Standard, and Tricare Extra. Tricare Prime is based on an HMO concept, requiring that one specifically enroll in the program, active duty members being enrolled automatically).

Those enrolled in Tricare Prime are assigned to a Primary Care Provider (PCP), usually the local military medical facility (base hospital).

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preview essay on MEDI-CAL AND TRICARE
  • Pages: 4 (1000 words)
  • Document Type: Essay
  • Subject: Unsorted
  • Level: Masters
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