Medi-Cal is the California Medicaid program providing services and essential health benefits to certain low-income seniors, pregnant women, families with children and people with disabilities. As a public health insurance option, services for seniors include wellness programs, chronic disease management, hospitalization and doctors visits, physical therapy, prescription drugs and mental health treatment.
To be eligible for Medi-Cal services and benefits, seniors must be either blind, disabled or at least 65 years old and meet the following income and asset requirements:
- Earn under $16,395 per year as an individual or under $22,108 as a married couple
- Have no more than $2,000 in assets for an individual or $3,000 in assets for a married couple, excluding furnishings, personal items, one vehicle and primary home
Seniors may also qualify for Medi-Cal if they:
- Receive Supplemental Security Income
- Reside in a nursing home or intermediate care facility
- Are enrolled in a refugee assistance program
- Are in need of cervical and/or breast cancer treatment as indicated by proper screening
For more information about Medi-Cal, call (800) 541-5555 or apply online.
Seniors enrolled in Medi-Cal may also benefit from one of two waivers: the Multipurpose Senior Services program and the Assisted Living waiver. It should be noted that these waivers are not entitlement programs, so individuals who qualify may be placed on a waiting list to receive services.
Multipurpose Senior Services Program
The Multipurpose Senior Services program is provided through the federal Home and Community-Based Medicaid waiver, and Medi-Cal members aged 65 and older may be eligible to participate in MSSP if they’re certified as requiring nursing facility level of care. MSSP provides services to seniors with the aim of delaying or preventing entry into a nursing home facility, and they can include personal care assistance, counseling, care management through a team of social workers and nurses, transportation services, home modifications and respite for caregivers.
El Dorado County residents can find out more about MSSP by calling (530) 621-6278.
Assisted Living Waiver
The Medi-Cal Assisted Living waiver provides transition services for seniors, helping them move to a residential care facility or public subsidized housing from a nursing home. While participants are required to pay for their own room and board, the cost is discounted to $1,039.37 for those who receive an SSI of $1,173.37 and $1,059.37 for individuals with an income of $1,193.37 or higher. Covered services include skilled nursing care, meals, transportation and housekeeping services.
Cameron Park residents must be willing to move to an assisted living facility in one of the following California counties to receive services: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma.
Additionally, Medi-Cal members hoping to enroll in the ALW must first work with a Care Coordination Agency to undergo an assessment of care needs.