Established by President Lyndon B. Johnson in 1965, Medicaid is the national health coverage program for low-income children, adults, seniors and people with disabilities. It is jointly funded by state and federal governments and administered by each state.
In California, the Medicaid program is known as Medi-Cal. To qualify for coverage, seniors 65 and older need to meet the following income and asset limits:
- Earn no more than $1,242 a month when applying as a single
- Earn no more than $1,682 a month when applying with a spouse
- Own a maximum of $2,000 in countable assets as a single
- Own a maximum of $3,000 in countable assets as a couple
Income from all sources is counted, including pension payments, alimony and investment interest. Assets include cash, bonds and all real estate except the applicant’s principal residence. One vehicle, personal belongings, household furnishings and a non-revocable burial trust are also exempt.
Seniors who are on
Supplemental Security Income are automatically covered under Medi-Cal. Seniors with incomes that exceed Medi-Cal limits may qualify for Medi-Cal coverage on a
Share of Cost basis. Under a SOC agreement, seniors must pay all of their own medical expenses up to a predetermined limit, at which point Medi-Cal benefits begin.
California Assisted Living Waiver Seniors who are both Medi-Cal-eligible and need a nursing home level of care may qualify for services through the
Assisted Living waiver, a Medi-Cal home and community-based waiver. The ALW helps prevent or delay nursing home placement among low-income seniors by supplementing services in an assisted living setting.
A registered nurse assesses seniors in Gilroy through an area Care Coordination Agency. If approved for the ALW, seniors are responsible for the room-and-board portion of their monthly assisted living costs at an
ALW program-participating facility located within Santa Clara County. Additional support services may include medication management, personal care, transportation, homemaker services and physical therapy as prescribed through the ALW assessment.
For more information on Medi-Cal and the ALW, contact the
Institute on Aging, the CCA for Santa Clara County, at (408) 474-0679