Medicaid was introduced by the federal government in 1965 to meet the health care needs of low-income Americans with limited resources. This jointly funded program is regulated at the federal level and administered by individual state governments.
California’s Medicaid program, called Medi-Cal, provides essential health care services to one in four Californians, including seniors over age 65 and those with disabilities. U.S. citizens and legal California residents are eligible for full-scope Medi-Cal coverage if they meet the program’s income and asset guidelines:
- Individuals are limited to $1,366 in monthly income and $2,000 in total assets.
- Married couples are allowed $1,842 income per month and up to $3,000 in assets.
Income from all sources counts, including earnings, investment dividends, pensions, Social Security and SS disability benefits and IRA and 401K distributions. Assets that count include cash, bank and retirement account balances, investments and real estate. Some assets are excluded including a main home, one vehicle, personal belongings and household furnishings.
California residents assessed as needing nursing home care can qualify for institutional Medi-Cal coverage at any income level if they meet the program’s asset limits. Seniors receiving federal Supplemental Security Income benefits are enrolled in Medi-Cal automatically and qualify for full-scope coverage.
There are options available to help other Concord seniors qualify for Medi-Cal coverage if they’re over the income and asset limits.
- Those with high medical bills may qualify through a share of cost. Based on a predetermined share amount, excess income can be spent down on medical bills to the required monthly qualification limit.
- Married seniors may receive coverage if only one spouse applies through allowed transfers of up to $3,160.50 in monthly income and $126,420 in joint assets to a non-applicant spouse.
Seniors can
apply for Medi-Cal coverage online, by calling (800) 300-1506 or by visiting the
Contra Costa County Employment and Human Services office at 300 Ellinwood Way in Pleasant Hills.
Medi-Cal HCBS Assisted Living Waiver The
Assisted Living waiver is a Medi-Cal home and community-based services program available to seniors and disabled adults who require an intermediate level of care normally provided in a nursing home or are at risk of admission if assistance isn’t received. The ALW is specifically designed to help seniors move to or stay in an assisted living setting to promote independence and quality of life.
To qualify for the program, Concord residents must be aged 21 or older and:
- Enrolled in Medi-Cal with full-scope coverage and zero share of cost
- Be able to live in an assisted living setting safely with supports available through the waiver program
Approved program participants are responsible for paying room-and-board costs, but the waiver covers the cost of various services in an assisted living facility, including:
- Nursing home transition assistance
- Care coordination
- Medication administration
- Daily meals and snacks
- Personal care
- Assistance with daily living activities, such as bathing, dressing and eating
- Housekeeping and laundry
- Recreational and social programs
- Transportation
As a Medi-Cal pilot program, the ALW is only available at participating, state-licensed
assisted living facilities in Contra Costa and 14 other California counties. There are a limited number of waiver slots available statewide, and qualified seniors may face a wait to receive services.
To learn more about the program or to schedule an assessment to determine medical eligibility, Concord seniors can contact the nearest Care Coordination Agency,
Rehab Services of Northern California in Pleasant Hills, at (925) 682-6330.