The federal government provides funding for low-income people, the blind or disabled, and the medically-needy to help pay for a range of medical services from authorized providers. The state-run Medicaid program in California is known as Medi-Cal.
Services provided by Medi-Cal include in-home supportive services (IHSS) for seniors who wish to remain in their own home, doctor and hospital visits, prescription drugs, surgery, diagnostics, transportation for approved purposes, medical supplies and more.
There are over 90 different categories of Medi-Cal coverage available, and you may either qualify for full-scope or partial-scope coverage under one of these categories. The following list contains the three most common categories of Medi-Cal for seniors in Bakersfield.
The main eligibility requirements for Medi-Cal are as follows:
- Minimum 65 years of age, or disabled, or blind
- Legal California resident
- Income under the maximum allowed – currently 138% of the Federal Poverty Level (FPL) – $1,436 a month for individuals in 2019
- Assets under the maximum allowed – currently $2,000 in 2019. Excludes home, vehicle and other non-countable assets
The list of eligibility requirements above should only be used as a general rule to get started in your research of the many Medi-Cal options available which each have their own requirements.
In any case, no matter which category of Medi-Cal you qualify for, payments for assisted living are not an entitlement in California. This means that neither the federal or state Medicaid programs will pay for all costs related to assisted living, and there may be a waiting list to receive services. There is a workaround for this, however, which is known as the Assisted Living Waiver (ALW) program; this waiver will be explained below.
To read more about Medi-Cal and find out which category you could quality for, visit the C4Yourself website and create an account. Bakersfield residents can also contact the Kern County Department of Human Services at (661) 631-6000 to request more information on Medi-Cal.
Assisted Living Waiver (ALW) Program
As mentioned above, the federal and state Medicaid programs, including Medi-Cal, will not directly pay for assisted living. To bypass this restriction, many states have implemented what are known as Medicaid Waivers. In California, the only relevant waiver is the Assisted Living Waiver (ALW) program.
This waiver is for seniors who have been assessed and a determination made that they need a nursing facility level of care, but would prefer to live in assisted living. In doing so, the state saves money by keeping people out of expensive nursing homes for longer.
The Assisted Living Waiver (ALW) can only be used in conjunction with Medi-Cal coverage, which means that applicants must meet the eligibility requirements and already be enrolled in Medi-Cal.
Applications for the ALW can only be made through authorized Care Coordination Agencies (CCA) in various locations throughout the state. Residents of Kern County should contact Partners in Care Foundation at (818) 837-3775 or send a message via the website to begin the application process.