One in four California residents are enrolled in Medicaid, the nationwide health protection plan for those who can’t afford medical care, including children, adults with disabilities and the elderly. It includes coverage for primary, emergency and long-term care services.
Medicaid is jointly funded by federal and state governments and administered at the state level. In California, the program is known as Medi-Cal. To qualify for free Medi-Cal coverage, seniors either need to be Supplemental Security Income recipients or meet the following financial criteria:
- Have a monthly income of $1,242 per month or less when applying as a single, or
- Have a combined monthly income of $1,682 or less when applying with a spouse, and
- Own no more than $2,000 in countable assets as a single, or
- Own no more than $3,000 in countable assets as a couple
Some assets are exempt, including one vehicle, clothing, household furnishings, a non-revocable burial trust and a home in which either the applicant and/or their spouse lives.
If only one spouse in a married couple is seeking Medi-Cal coverage, the non-applicant spouse is entitled to a minimum monthly maintenance needs allowance of up to $3,161, which can be transferred from the applicant spouse without penalty. The non-applicant can also keep up to $126,420 of the couples’ countable assets under the community spouse resource allowance clause.
For more information and assistance with Medi-Cal enrollment, contact the
Access Call Center at (866) 262-9881.
Assisted Living Waiver The
Assisted Living Waiver is a Medicaid home and community waiver that funds support services for seniors who meet the Medicaid criteria for nursing home placement.
To qualify for the ALW, seniors must be 65 or older, have Medi-Cal coverage with no share-of-cost and wish to reside in an assisted living facility. Under the program, participants pay the room-and-board portion of their monthly costs, and Medi-Cal funds services participants need to remain safely in assisted living, which may include:
- Skilled and intermittent nursing
- Medical supplies and equipment
- Personal care
- Housekeeping
- Recreational programming
- Help self-administering medication
- Transportation
- Case management
The ALW also provides transition support for seniors who are moving from a nursing facility to an assisted living setting.
Participants are placed in an assisted living facility operated by a participating ALW provider. Seniors who meet program criteria may be placed on a waiting list as there are statewide ALW enrollment limits.
For more information and to request an ALW assessment, contact
GrandCare, the ALW Care Coordinator Agency for San Diego County, at (866) 554-2447.