Medicaid, the national and state-funded health care program, provides medical assistance to low-income Irvine residents of all ages. Doctor visits, hospital services and nursing home care are all covered by Medicaid. In California, Medicaid is administered by Medi-Cal, a branch of California’s Department of Health Care Services. However, for help with long-term care costs, residents can apply for one of the state’s Medi-Cal waivers.
Applicants age 65 and older can still qualify for Medi-Cal under the Aged & Disabled Federal Poverty Level Medi-Cal. To qualify, applicants must earn no more than $1,271 (individuals) or $1,720 (couples) per month and possess no more in assets than $2,000 for individuals or $3,000 for couples. There are some exclusions to countable assets, including one car, burial funds, the primary residence and household goods.
If your monthly income is higher than the Medi-Cal limit, you may still be eligible through the Share of Cost program, which works like a deductible since it’s a fixed amount in medical services seniors must pay before Medi-Cal begins to pay in any given month.
Applications for Medi-Cal may be completed online, at Orange County United Way in Irvine or by phone at (800) 300-1506.
Assisted Living Waiver
The ALW is available to those who qualify for Medi-Cal and are willing to live in an assisted living facility instead of a nursing home. ALW services include recreational activities, transportation services, medication administration, 24-hour staff, assistance with activities of daily living, meals, housekeeping and laundry.
Prescreening assessments are done over the phone, followed by an appointment with a registered nurse. To learn more or apply, contact the administrator for Access TLC Home Health Care at (818) 551-1900 or (800) 852-9887. You may also email cca@accesstlchomehealth.com.
In-Home Operations Waiver
Medi-Cal beneficiaries who wish to remain in their homes or communities may be eligible for the IHO Waiver. Participant level of care is determined by medical need, which is substantiated by a licensed physician who conducts a home evaluation and creates a plan of treatment. Personal care services, nursing home care and case management are all part of the IHO Waiver. To learn more, contact the WPCS hotline at (916) 552-9214 or call DHCS Integrated Systems of Care Division Hotline at (833) 388-4551. You may also email IHOWaiver@dhcs.ca.gov.
Multipurpose Senior Services Program
The MSSP is available for seniors who qualify for Medi-Cal. Recipients of the MSSP would typically require a nursing facility level of care were it not for the services provided by the program. These include:
- Personal care and chore services
- Environmental modifications
- Transportation
- Adult day care
- Home-delivered or congregant meals
- Counseling
- Translation services
- Case management
- Minor home repairs
Seniors serviced by MSSP may not be simultaneously served by another waiver, and a limited number of spots are available. For more information or to apply, contact the California Department of Aging at (800) 510-2020.