Medicare vs Medi-Cal vs IHSS vs VA
These four programs get confused constantly. They are different things and many families qualify for more than one.
Side by side
| Medicare | Medi-Cal / IHSS | VA | |
|---|---|---|---|
| Who runs it | Federal | State and county | Federal (Dept. of Veterans Affairs) |
| Main test | Age 65+ or disability | Income and assets | Military service |
| Pays for at home | Skilled nursing and therapy, short-term | Personal care hours (IHSS), long-term care | Home health, aide services, monthly cash |
| Can family be paid? | No | Yes — IHSS pays a caregiver who may be a family member | Yes — through Veteran-Directed Care |
| Typical cost to you | $0 for covered visits | $0 to low, depending on income | $0 for most |
| Where to apply | Through your doctor | Your county social services office | VA, or a free County Veterans Service Officer |
How to apply for each
- 1Medicare home healthAsk the doctor. It requires a physician's order and a face-to-face visit. No application form for the family to fill in.
- 2Medi-CalApply through your county social services office or at CoveredCA. Asset rules have changed in recent years — do not assume you are over the limit.
- 3IHSSApply through your county IHSS office. A social worker visits and assesses how many hours are approved.
- 4VA benefitsGo to a County Veterans Service Officer. Their help is free and they know the forms. Never pay anyone to file a VA claim.