If you or a loved one needs assistance with healthcare costs, Medi-Cal may be an option to consider. While Medi-Cal provides healthcare coverage for low-income individuals and families, it can also be a resource for seniors and those with disabilities. In this post, we’ll explore Medi-Cal benefits for assisted living, eligibility requirements, the application process, and more.
Assisted Living Benefits through Medi-Cal
Medi-Cal offers an Assisted Living Waiver (ALW) program to qualified seniors and individuals with disabilities. The program provides financial assistance for room and board, meals, transportation, personal care services, and other expenses associated with assisted living. However, the ALW program has a waitlist of three years or more in some areas.
Additionally, for those who are eligible, Medi-Cal may also pay for in-home support services (IHSS) to help with activities of daily living, such as bathing, grooming, and meal preparation. IHSS allows seniors and those with disabilities to remain in their homes and avoid moving to an assisted living facility.
Eligibility Requirements for Medi-Cal
The eligibility requirements for Medi-Cal vary depending on the program. For the ALW program, individuals must:
Be Eligible for Nursing Facility Level of Care
For ALW eligibility, the applicant must need a nursing facility level of care, as determined by a comprehensive assessment by the State. This means that the individual will require daily assistance with activities of daily living.
Be 65 or Older or Have a Disability
The individual must be 65 years of age or older, have a disability, or meet the eligibility requirements for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
Meet Medi-Cal Income Requirements
The individual must also meet the Medi-Cal income requirements, which vary depending on the program and location. In general, the income limit for Medi-Cal is 138% of the federal poverty level.
Have Less Than $2,000 in Countable Assets
The individual must have less than $2,000 in countable assets, including cash, bank accounts, and investments. Certain assets, such as a primary residence and one vehicle, are excluded from the asset limit for Medi-Cal.
How to Apply for Medi-Cal
To apply for Medi-Cal, individuals can apply online at the Covered California website or in person at a local county human services agency. The application will require personal and financial information, and a determination of eligibility will be made within 45 days.
If you are applying for the ALW program, you may need to provide additional information, such as a copy of the comprehensive assessment, to show that you meet the nursing facility level of care requirement.
Frequently Asked Questions
What Is the Income Limit for Medi-Cal?
The income limit for Medi-Cal varies depending on the program and location. In general, the income limit is 138% of the federal poverty level. However, some programs may have higher income limits, such as the ALW program.
What Are Countable Assets for Medi-Cal?
Countable assets for Medi-Cal include cash, bank accounts, investments, and other assets that are not excluded. Certain assets, such as a primary residence and one vehicle, are excluded from the asset limit for Medi-Cal.
Can I Qualify for Medi-Cal Even If I Have a High Income?
It may be possible to qualify for Medi-Cal even if you have a high income. Some Medi-Cal programs have higher income limits, and there are also ways to reduce your countable income, such as through a Qualified Income Trust (QIT) or a Special Needs Trust.
Medi-Cal can be a valuable resource for seniors and those with disabilities who need assistance with healthcare costs. From the ALW program for assisted living benefits to IHSS for in-home support services, Medi-Cal offers a range of programs and services to meet the needs of those in need. If you or a loved one think you may qualify for Medi-Cal, be sure to explore your options and apply today.