Medicaid is the federally regulated, national health care program that provides coverage for low-income Americans regardless of age. The program is funded by the federal government in conjunction with individual states and administered at the state level.
The California Medicaid program, Medi-Cal, provides low-cost or free health care services to seniors aged 65 or older as well as blind or disabled adults who are U.S. citizens or legal residents. Those receiving federal Supplemental Security Income automatically qualify for full-scope Medi-Cal benefits, but other senior applicants must meet income and resource limits of:
- $1,242 in monthly income and up to $2,000 in countable resources for a single person
- $1,682 in monthly income and up to $3,000 in countable resources for a couple applying together
Medi-Cal counts income from all sources, including pensions, stock dividends, Social Security and disability benefits. Some resources are exempt, such as an applicant’s home, one vehicle, household items and personal belongings, including jewelry.
Seniors in need of long-term nursing home care can qualify for Medi-Cal institutional coverage regardless of income, but the basic resource limits still apply.
Those who are over the income limit but face high medical bills may be eligible for coverage with a
share of cost. Medi-Cal calculates the applicant’s share based on excess income, and coverage begins once this amount is spent on medical bills.
Married seniors have options available to reduce over-the-limit income and assets to qualify for coverage if just one spouse applies.
- Up to $3,160.50 in monthly income can be disregarded as a living allowance for a non-applicant spouse
- Up to $126,420 in jointly owned assets can be excluded as a community spouse resource allowance
Seniors can
apply for Medi-Cal coverage online, in person at the
Department of Public Social Services office in Norco or over the phone by calling (800) 300-1506.
Medi-Cal Assisted Living Waiver Those who are Medi-Cal eligible and qualified for long-term care services can apply for the Assisted Living waiver as an alternative to institutional care. This Home and Community-Based Services waiver program is in place to limit nursing home admissions to reduce the cost of care and provide improved quality of life for seniors and those with disabilities. The waiver doesn’t pay the room-and-board portion of facility fees, but it covers other costs such as:
- Care coordination and transition services
- Recreational activities
- Housekeeping and laundry services
- Meals and snacks
- Assistance performing activities of daily living
- Personal care
- Social services
- Assistance with administering medication
- Transportation
Eastvale residents aged 21 or older may qualify for the ALW if they:
- Have full-scope Medi-Cal coverage with no share of cost
- Have been assessed as needing nursing home-level care
- Are able to live outside a nursing facility without safety concerns
- Are willing to move to a participating, licensed assisted living facility
Because the ALW isn’t an entitlement program and services are provided on a first-come, first-served basis, there may be a waiting list for available slots.
Seniors in Eastvale can contact one of the five
Care Coordination Agencies serving Riverside County to learn more about the ALW or schedule a qualifying assessment.