The national health insurance program Medicaid provides over 65 million Americans with free or low-cost health care services. Each state administers its own Medicaid program according to federal guidelines. The California program called Medi-Cal ensures low-income elderly residents receive a wide range of benefits, including:
- Doctor and specialist visits
- Hospital and emergency room treatment
- Diagnostics and preventive care
- Prescription medications
- Long-term care in a nursing home
Qualifying for Medi-Cal for Long-Term Care To qualify for Medi-Cal coverage for long-term care, Lodi residents must have legal immigration status or be U.S. citizens and aged 65 or older. Adults under age 64 who are blind or disabled may also qualify. Applicants must meet the program’s income and assets limits of:
- $1,242 in monthly income and $2,000 worth of assets if single
- $1,682 of income per month and $3,000 worth of assets if married and applying jointly
All sources of income count toward the above limits, but some assets are automatically disregarded including an applicant’s personal belongings, irrevocable burial trusts, an owner-occupied principal home, household goods and one automobile.
Exceptions to Medi-Cal Financial Limits Those receiving
Supplemental Security Income are automatically enrolled in Medi-Cal with full-scope benefits. The income limit doesn’t apply to seniors assessed as needing nursing home care as long as they meet the asset limit and Medi-Cal’s other eligibility criteria.
Lodi residents who exceed the income limit but have high medical bills may become eligible through a
share of cost. With this qualification method, Medi-Cal determines the applicant’s share based on their excess income, and this amount must be put toward outstanding medical bills to reach the eligibility threshold.
Lodi seniors can
apply for Medi-Cal coverage online or by calling
Covered CA at (800) 300-1506.
Medi-Cal Assisted Living Waiver California Medicaid offers an
Assisted Living waiver in certain counties, including San Joaquin
. The purpose of the waiver is to reduce premature nursing home placements by giving eligible seniors the alternative of receiving long-term care in
approved assisted living communities.
Lodi residents can qualify for the ALW if they’re aged 65 or older or aged 64 and younger and disabled and are:
- Eligible for full-scope Medi-Cal with no share of cost
- Assessed as needing a nursing home level of care but physically and cognitively capable of living in a community setting
Those approved for the ALW are responsible for paying the room-and-board portion of their assisted living fees, but the waiver reimburses the facility for various provided services, such as:
- Costs associated with transitioning from a nursing home
- Care coordination
- Meals and snacks
- Housekeeping and laundry
- Help with activities of daily living
- Assistance with self-administration of medications
- Social and recreational programming
- Periodic skilled nursing care
- Nonmedical transportation
Not all assisted living facilities in San Joaquin County participate in the ALW program, and enrollment is capped by Medi-Cal, so eligible seniors may be placed on a waiting list based on availability.
To learn more about the ALW program or begin the application process, Lodi residents can contact
Infinity Care Services of Stockton at (209) 264-0300 or their choice of four other
Care Coordination Agencies serving San Joaquin County.