People often confuse the two or use the names interchangeably despite the fact that they are two very different programs. Both Medi-Cal and Medicare are federally funded healthcare programs; however, the similarities stop there. Medicare is an “entitlement” program, meaning that as long as you worked and paid into the program you are “entitled” to benefits when you turn 65 years old. You will automatically be enrolled in Medicare. Basic Medicare is free; however, there are four parts to Medicare and if you choose to participate in the additional parts you will pay a premium each month. Medi-Cal is a “needs” based program, meaning you must demonstrate a financial “need” for benefits to be eligible. If you qualify, participation in Medi-Cal is free.