More than 72 million Americans receive health care services through Medicaid, the federal and state government-funded program that serves low-income families with children, pregnant women and blind, disabled and elderly adults. Medi-Cal, the California Medicaid program, provides eligible state residents with free or low-cost medical services that include preventive care, doctors appointments, hospital and emergency care, physical therapy, prescriptions and dental services.
Seniors may qualify for Medi-Cal benefits if they meet these income and resource requirements:
- Maximum yearly income of $16,146 for individuals and $21,892 for couples
- Total countable resources of $2,000 or less for individuals and $3,000 or less for couples
Income from all sources counts, but some resources are excluded, such as a principal home, household furnishings, personal effects, an irrevocable burial trust and one vehicle.
Medi-Cal covers nursing home care for seniors who meet the above resource requirements. There is no income limit to qualify. Those who receive federal Supplemental Security Income are automatically enrolled in Medi-Cal.
Seniors with high medical bills who exceed the income limit may be eligible for Medi-Cal coverage through a
share of cost. An applicant’s excess income determines the required share amount, which must be used to pay medical bills before coverage begins.
El Dorado County seniors can
apply for Medi-Cal coverage online, by visiting the nearest
Health and Human Services office or by calling (800) 300-1506.
Assisted Living Waiver Medi-Cal offers an
assisted living waiver program to limit nursing home admissions by giving seniors the option of residing in an assisted living setting. This pilot program is only available in 15 counties throughout the state, including neighboring Sacramento County. To take advantage of the waiver, El Dorado County residents must be over age 21 and:
- Qualify for full Medi-Cal benefits without a share of cost
- Need the level of care provided in a nursing facility
- Be able to live safely in an assisted living setting
- Be willing to relocate to a county that participates in the program
The ALW doesn’t cover assisted living facility room-and-board charges, but it does pay for related services such as:
- Nursing facility transition costs
- Social services and care coordination
- Meals and snacks
- Laundry and housekeeping
- Personal care and assistance with activities of daily living
- Medication administration assistance
- Recreational activities
- Intermittent skilled nursing care
- Transportation
To learn more or request an assessment to start the ALW application process, El Dorado County residents can contact
Elder Options at (530) 626-6939 or the
Care Coordination Agency of their choice.