{"id":189,"date":"2026-02-16T20:56:35","date_gmt":"2026-02-16T20:56:35","guid":{"rendered":"https:\/\/www.freeway.com\/knowledge-center\/?p=189"},"modified":"2026-03-09T15:53:26","modified_gmt":"2026-03-09T15:53:26","slug":"whats-difference-medi-cal-medicaid-insurance","status":"publish","type":"post","link":"https:\/\/www.freeway.com\/knowledge-center\/health-insurance\/understanding-health-insurance\/whats-difference-medi-cal-medicaid-insurance\/","title":{"rendered":"What\u2019s\u00a0the Difference Between Medi\u2011Cal and Medicaid Insurance?\u00a0"},"content":{"rendered":"\n<p>Medi-Cal is Medicaid \u2014&nbsp;it\u2019s&nbsp;simply&nbsp;<a href=\"https:\/\/www.freeway.com\/knowledge-center\/health-insurance\/enrolling-in-a-health-insurance-plan\/health-insurance-open-enrollment-in-california\/\" target=\"_blank\" rel=\"noreferrer noopener\">California\u2019s version of the Medicaid program<\/a>. The confusion comes from the different names and the fact that each state runs Medicaid under its own rules, which can affect eligibility, coverage, and enrollment.&nbsp;<\/p>\n\n\n\n<p>Some people may not realize that states have their own&nbsp;Medicaid&nbsp;programs, and&nbsp;it\u2019s&nbsp;easy to mix up&nbsp;the similar-sounding names. However, if&nbsp;you\u2019re&nbsp;a California resident, state-specific information about&nbsp;<a href=\"https:\/\/www.freeway.com\/insurance-options\/health-insurance\/types-of-health-insurance\/medical-health-insurance\/\" target=\"_blank\" rel=\"noreferrer noopener\">Medi-Cal<\/a>&nbsp;will be the most relevant to your situation.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Whether&nbsp;you\u2019re&nbsp;a current Californian looking for affordable care or&nbsp;you\u2019re&nbsp;moving&nbsp;from another state, Medi-Cal can be a valuable resource. In this guide, the Freeway team shares the distinction between Medi-Cal and Medicaid, including basic eligibility requirements,&nbsp;what\u2019s&nbsp;included, and how to apply.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What Is Medi\u2011Cal? California\u2019s Medicaid Program<\/strong>&nbsp;<\/h2>\n\n\n\n<p>Medi\u2011Cal is a California government program that offers affordable health coverage to low-income individuals who make below a certain percentage of the federal poverty level. If you qualify, the government subsidizes your care so you can get treatment at a low or no cost.&nbsp;It\u2019s&nbsp;there to make sure you can see a doctor when&nbsp;you\u2019re&nbsp;sick, get medicine when you need it, and even get regular checkups to keep you healthy.&nbsp;<\/p>\n\n\n\n<p>There are multiple levels of Medi-Cal plans. Part A primarily covers inpatient hospital and emergency care. Most people&nbsp;don\u2019t&nbsp;pay anything at all for Part A, as&nbsp;it\u2019s&nbsp;covered by taxes. Part B covers outpatient care like regular&nbsp;doctor\u2019s&nbsp;appointments and ongoing care. Depending on your situation, you may have to pay a premium for Part B care. However, it will be at a&nbsp;majorly&nbsp;discounted rate.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Who\u2019s Eligible for Medi-Cal?<\/strong>&nbsp;<\/h2>\n\n\n\n<p>Because Medi-Cal is designed specifically to help low-income Californians, you&nbsp;have to&nbsp;fit certain requirements to qualify and&nbsp;<a href=\"https:\/\/www.freeway.com\/knowledge-center\/health-insurance\/about-to-lose-your-medicaid\/\" target=\"_blank\" rel=\"noreferrer noopener\">get subsidized health coverage<\/a>. To see if you can get Medi\u2011Cal, they look at a few things:&nbsp;<\/p>\n\n\n\n<ul>\n<li><strong>Income:\u00a0<\/strong>In California, you need to make less than 138% of the federal poverty level to qualify for Medi-Cal. The exact amount will depend on your family size.\u00a0<\/li>\n\n\n\n<li><strong>California residency:<\/strong>\u00a0Because Medi-Cal is state-specific, you\u00a0have to\u00a0live in California to get Medi\u2011Cal. You do not always have to be a U.S. citizen or have a green card.\u00a0<\/li>\n\n\n\n<li><strong>Citizenship or immigration status:<\/strong>\u00a0As of January 1, 2026, you need to have a satisfactory immigration status to enroll in Medi-Cal. However, if you were already enrolled before that deadline, you can still renew regardless of your immigration status.\u00a0<\/li>\n\n\n\n<li><strong>Age:<\/strong>\u00a0Adults\u00a0ages\u00a019 and older can apply, while children under 19 can qualify through family plans.\u00a0<\/li>\n\n\n\n<li><strong>Family size:\u00a0<\/strong>Medi-Cal eligibility is linked to the federal poverty level, which varies based on family size. A single income supporting one person may not qualify, but that same income supporting a family might.\u00a0<\/li>\n\n\n\n<li><strong>Pregnancy:<\/strong>\u00a0If\u00a0you\u2019re\u00a0pregnant and have a low income, you may qualify for prenatal and postnatal healthcare through.<\/li>\n\n\n\n<li><strong>Disability:<\/strong>\u00a0If you have a disability, no matter how old you are, you may be able to get Medi\u2011Cal if your income and savings are within certain limits.\u00a0<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What Is Medicaid? A Nationwide Program<\/strong>&nbsp;<\/h2>\n\n\n\n<p>Medicaid is a nationwide program that helps people in the United States get cheap health insurance. To&nbsp;<a href=\"https:\/\/www.freeway.com\/knowledge-center\/health-insurance\/understanding-health-insurance\/health-insurance-subsidy-what-is-it-and-do-i-qualify\/\" target=\"_blank\" rel=\"noreferrer noopener\">qualify for Medicaid<\/a>, you have to have a low income. Typically, you&nbsp;have to&nbsp;make below a certain percentage of the federal poverty level. Each state administers its own Medicaid program, so details can vary by state.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Who\u2019s Eligible for Medicaid?<\/strong>&nbsp;<\/h2>\n\n\n\n<p>In the United States,&nbsp;access to Medicaid&nbsp;depends on rules set by the federal government and by each state.&nbsp;Therefore, the requirements for Medicaid eligibility may be a little different depending on where you live.&nbsp;<\/p>\n\n\n\n<p>In most cases, you can qualify if&nbsp;you\u2019re&nbsp;an adult with legal residency status who makes below the poverty threshold outlined in your state\u2019s&nbsp;<a href=\"http:\/\/www.medicaid.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">Medicaid<\/a>&nbsp;program. Children can also qualify under family plans. There can also be some special rules and exceptions if&nbsp;you\u2019re&nbsp;pregnant or disabled.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>Feature<\/strong>&nbsp;<\/td><td><strong>Medi-Cal<\/strong>&nbsp;<\/td><td><strong>Medicaid<\/strong>&nbsp;<\/td><\/tr><tr><td>What It Is&nbsp;<\/td><td>California\u2019s version of Medicaid&nbsp;<\/td><td>Federal Medicaid program administered by each state&nbsp;<\/td><\/tr><tr><td>Who Runs It&nbsp;<\/td><td>CA Dept. of Health Care Services + federal funding&nbsp;<\/td><td>Each state\u2019s Medicaid agency + federal funding&nbsp;<\/td><\/tr><tr><td>Eligibility Rules&nbsp;<\/td><td>California-specific income and immigration rules&nbsp;<\/td><td>Varies by state&nbsp;<\/td><\/tr><tr><td>Coverage&nbsp;<\/td><td>Includes all ACA essential health benefits&nbsp;<\/td><td>Includes federally&nbsp;required&nbsp;benefits + optional state add-ons&nbsp;<\/td><\/tr><tr><td>Enrollment Period&nbsp;<\/td><td>Year-round&nbsp;<\/td><td>Year-round&nbsp;<\/td><\/tr><tr><td>Extra Programs&nbsp;<\/td><td>Medi-Cal Dental, Medi-Cal Vision&nbsp;<\/td><td>Varies by state&nbsp;<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What Is Covered by Medi\u2011Cal?<\/strong>&nbsp;<\/h2>\n\n\n\n<p>Medi\u2011Cal coverage, just like&nbsp;<a href=\"https:\/\/www.freeway.com\/insurance-options\/health-insurance\/types-of-health-insurance\/covered-california\/\" target=\"_blank\" rel=\"noreferrer noopener\">Covered California<\/a>&nbsp;plans, includes the 10 comprehensive services known as \u201cessential health benefits\u201d as&nbsp;designated&nbsp;by the Affordable Care Act.<strong>&nbsp;<\/strong>That means Medi-Cal plans must include:&nbsp;<\/p>\n\n\n\n<ul>\n<li>Outpatient (ambulatory) services (doctor visits)\u00a0<\/li>\n\n\n\n<li>Emergency services\u00a0<\/li>\n\n\n\n<li>Hospitalization\u00a0<\/li>\n\n\n\n<li>Maternity and newborn care\u00a0<\/li>\n\n\n\n<li>Mental health and substance use disorder services, including behavioral health treatment\u00a0<\/li>\n\n\n\n<li>Prescription drugs\u00a0<\/li>\n\n\n\n<li>Programs such as physical and occupational therapy (known as rehabilitative and habilitative services) and devices\u00a0<\/li>\n\n\n\n<li>Laboratory services\u00a0<\/li>\n\n\n\n<li>Preventive and wellness services and chronic disease management\u00a0<\/li>\n\n\n\n<li>Children\u2019s services, including immunization, oral, and vision care\u00a0<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img decoding=\"async\" width=\"1000\" height=\"667\" src=\"https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2023\/07\/FWY-whats-difference-medi-cal-medicaid-insurance-2.jpg\" alt=\"\" class=\"wp-image-12600\" srcset=\"https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2023\/07\/FWY-whats-difference-medi-cal-medicaid-insurance-2.jpg 1000w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2023\/07\/FWY-whats-difference-medi-cal-medicaid-insurance-2-300x200.jpg 300w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2023\/07\/FWY-whats-difference-medi-cal-medicaid-insurance-2-768x512.jpg 768w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2023\/07\/FWY-whats-difference-medi-cal-medicaid-insurance-2-750x500.jpg 750w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2023\/07\/FWY-whats-difference-medi-cal-medicaid-insurance-2-294x196.jpg 294w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2023\/07\/FWY-whats-difference-medi-cal-medicaid-insurance-2-320x213.jpg 320w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2023\/07\/FWY-whats-difference-medi-cal-medicaid-insurance-2-285x190.jpg 285w\" sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/figure><\/div>\n\n\n<h2 class=\"wp-block-heading\"><strong>Does Medi-Cal Include Dental and Vision Coverage?<\/strong>&nbsp;<\/h2>\n\n\n\n<p>In addition to standard health coverage as required under the Affordable Care Act, Medi\u2011Cal also offers dental and&nbsp;<a href=\"https:\/\/www.freeway.com\/insurance-options\/health-insurance\/types-of-health-insurance\/medical-health-insurance\/medical-vision-benefits\/\" target=\"_blank\" rel=\"noreferrer noopener\">vision plans<\/a>&nbsp;for qualifying adults and children. However, they may come at an added cost. Dental plans may also cover some orthodontic care in certain situations. To learn more about&nbsp;<a href=\"https:\/\/www.freeway.com\/insurance-options\/dental-insurance\/\" target=\"_blank\" rel=\"noreferrer noopener\">dental benefits<\/a>&nbsp;and eligibility, you can contact your nearest Freeway Insurance agent or visit&nbsp;<a href=\"http:\/\/www.denti-cal.ca.gov\/WSI\/Default.jsp?fname=Default\" target=\"_blank\" rel=\"noreferrer noopener\">Denti\u2011Cal<\/a>.&nbsp;<\/p>\n\n\n\n<p>Vision benefits are also available for those with full\u2011scope Medi\u2011Cal benefits. All Medi\u2011Cal members are eligible for a routine eye exam once every&nbsp;24 months, at which time they can check the health of their eyes and&nbsp;determine&nbsp;if they need corrective lenses.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>How To Apply and Enroll in Medi-Cal (Year-Round Enrollment)<\/strong>&nbsp;<\/h2>\n\n\n\n<p>Enrolling in Medi-Cal is easy. You can directly apply online, over the phone, or at a county office.&nbsp;Or,&nbsp;you can work with a professional Freeway insurance agent who can walk you through the process.&nbsp;<\/p>\n\n\n\n<p>During the application,&nbsp;you\u2019ll&nbsp;share basic information about your income and&nbsp;household. You may have to&nbsp;submit&nbsp;documents&nbsp;verifying&nbsp;your income. Once&nbsp;you\u2019re&nbsp;approved,&nbsp;you\u2019ll&nbsp;have to complete a yearly income verification check to make sure you still qualify.&nbsp;<\/p>\n\n\n\n<p>You can enroll in Medi-Cal at any time of year, so you&nbsp;don\u2019t&nbsp;have to worry about limited enrollment deadlines. Unlike&nbsp;<a href=\"https:\/\/www.freeway.com\/insurance-options\/health-insurance\/health-insurance-special-enrollment\/\" target=\"_blank\" rel=\"noreferrer noopener\">open enrollment<\/a>&nbsp;for private health plans through the Covered California marketplace, which runs from November 1 through January, enrollment for&nbsp;<a href=\"https:\/\/www.freeway.com\/knowledge-center\/health-insurance\/enrolling-in-a-health-insurance-plan\/health-insurance-open-enrollment-in-california\/\" target=\"_blank\" rel=\"noreferrer noopener\">Medi\u2011Cal is open year\u2011round<\/a>.&nbsp;As long as you meet income restrictions, you can apply.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Need Help Finding Medi-Cal or Affordable Health Insurance? Freeway Can Help<\/strong>&nbsp;<\/h2>\n\n\n\n<p>As California\u2019s form of Medicare, Medi-Cal provides essential healthcare coverage to people across the state. Medi-Cal&nbsp;isn\u2019t&nbsp;a separate program from Medicaid, so you&nbsp;don\u2019t&nbsp;need to worry about&nbsp;applying to&nbsp;multiple programs. If you have a low income and struggle to get healthcare, Medi-Cal could be the answer.&nbsp;<\/p>\n\n\n\n<p>Finding the right healthcare can be a challenge, from&nbsp;determining&nbsp;which programs you qualify for to choosing a plan that fits your budget. Regardless of whether you qualify for Medi-Cal, the Freeway team is here to help.&nbsp;<\/p>\n\n\n\n<p>Freeway Insurance can help you&nbsp;determine&nbsp;your eligibility for California health coverage, then offer you an assortment of affordable health plans that fit your budget. Call&nbsp;<a href=\"tel:(800) 777%E2%80%915620\" target=\"_blank\" rel=\"noreferrer noopener\">(800) 777\u20115620<\/a>&nbsp;to speak with an agent,&nbsp;get&nbsp;your&nbsp;<a href=\"https:\/\/www.freeway.com\/insurance-options\/health-insurance\/\" target=\"_blank\" rel=\"noreferrer noopener\">free health insurance quote online,<\/a>&nbsp;or&nbsp;<a href=\"https:\/\/locations.freeway.com\/?_gl=1*4apfbe*FPAU*NjAyMDMxNDkuMTc2OTcxMjE4MQ..*_ga*MTA5NTY4NzMyOC4xNzIxODM2NjY3*_ga_3MMY02BBSR*czE3NzA0MDE4NDgkbzM0MyRnMSR0MTc3MDQwMjQ0MCRqNTkkbDAkaDY2MDcwMTk.*_fplc*REhSNjhVSjZoJTJCM1VoOE1yZXl4amt4cmRwJTJCSiUyQkNVeEY3VWJndGVldGVVUVU2bU9OWk1MZXhXM3lCd1prelZqbmc4SzMyJTJGTzZMMWtqZm9JQm1tR3NmdkJ0NjVpeFUlMkJSWkRQVnlaJTJCYk5PRGRJTCUyRmx1aGFRRDRxdzBhbmJFelElM0QlM0Q.\" target=\"_blank\" rel=\"noreferrer noopener\">visit our location<\/a>.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>FAQs<\/strong>&nbsp;<\/h2>\n\n\n\n<p>Learn more about how Medi-Cal and Medicaid work by reviewing these&nbsp;common questions&nbsp;and answers:&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Can Immigrants Qualify for Medi-Cal?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Yes, immigrants with&nbsp;appropriate legal&nbsp;residency status can qualify for Medi-Cal coverage. Prior to January 2026, undocumented immigrants were also eligible, and if you already have coverage, you can still renew it. However, the rules changed in January 2026, and undocumented immigrants are no longer able to enroll in new plans.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>How Do I Know If I&nbsp;Qualify for&nbsp;Medi-Cal or Medicaid?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>You can find out if you qualify by visiting the California Department of Healthcare Services website and using its eligibility tool.&nbsp;Or,&nbsp;you can work with an insurance agent to walk you through the process and check your eligibility.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>How Is Medi-Cal Funded?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Medi-Cal is funded by a combination of federal, state, and local taxes. Taxpayer money subsidizes coverage&nbsp;costs&nbsp;so people with the lowest incomes can still get healthcare at no or low cost. Depending on their coverage, Medi-Cal recipients may also contribute by paying a discounted premium.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Can I Have Both Medi-Cal and Private Insurance?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>You can have Medi-Cal and private coverage. If your employer offers coverage, you can use Medi-Cal for qualifying expenses that your&nbsp;employer&nbsp;plan&nbsp;doesn\u2019t&nbsp;cover. You can also&nbsp;purchase&nbsp;a marketplace plan alongside Medi-Cal, although you&nbsp;wouldn\u2019t&nbsp;be eligible for any extra subsidies if you already had full Medi-Cal coverage.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Can You Use Medi-Cal Outside of California?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>You can use your Medi-Cal coverage outside of California, but only for emergencies. Medi-Cal offers reimbursement for emergency services if you have a serious medical emergency while traveling out of state. However, it&nbsp;wouldn\u2019t&nbsp;cover routine care, so if you move or need healthcare in another state,&nbsp;you\u2019ll&nbsp;want to look at other options.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Medi-Cal is Medicaid \u2014&nbsp;it\u2019s&nbsp;simply&nbsp;California\u2019s version of the Medicaid program. The confusion comes from the different names and the fact that each state runs Medicaid under its own rules, which can affect eligibility, coverage, and enrollment.&nbsp; Some people may not realize that states have their own&nbsp;Medicaid&nbsp;programs, and&nbsp;it\u2019s&nbsp;easy to mix up&nbsp;the similar-sounding names. However, if&nbsp;you\u2019re&nbsp;a California resident, [&hellip;]<\/p>\n","protected":false},"author":1002630,"featured_media":12599,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[58],"tags":[100,101],"importance":[],"type-content":[],"acf":[],"_links":{"self":[{"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/189"}],"collection":[{"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/users\/1002630"}],"replies":[{"embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/comments?post=189"}],"version-history":[{"count":13,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/189\/revisions"}],"predecessor-version":[{"id":12723,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/189\/revisions\/12723"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/media\/12599"}],"wp:attachment":[{"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/media?parent=189"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/categories?post=189"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/tags?post=189"},{"taxonomy":"importance","embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/importance?post=189"},{"taxonomy":"type-content","embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/type-content?post=189"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}