Over 65 million low-income Americans receive free or low-cost health care coverage through Medicaid, a national, government-funded program that’s regulated federally and administered by each state. The California Medicaid program known as Medi-Cal provides coverage for one-quarter of the state’s population, including over 1.5 million elderly and disabled individuals. Those who qualify receive a wide range of essential services, including:
- Preventive care
- Hospital and emergency room care
- Prescription medications
- Doctor and specialist visits
- Physical therapy
- Dental and vision care
Qualifying for Medi-Cal Coverage Placerville seniors aged 65 and older are eligible for coverage if they’re American citizens or legal residents and have:
- A monthly income of $1,242 or less as an individual or $1,682 as a couple
- Countable resources of $2,000 or less as a single person or $3,000 as a married couple
Medi-Cal counts all sources of income but disregards some resources, including personal effects, one automobile, irrevocable burial trusts, a primary home and household goods.
The program provides coverage for long-term care in nursing homes for those who meet the above resource limits without any restriction on income. Seniors eligible for or receiving
Supplemental Security Income benefits are enrolled in full-scope Medi-Cal automatically.
Qualifying With a Share of Cost Those who exceed the income limits but have high medical bills may qualify for coverage with a
share of cost. The share required is determined by an individual’s excess income. Once this amount is put toward medical expenses, coverage can begin.
Deductions for Spousal Allowances Married seniors applying without their spouse may qualify even if they’re over the financial limits once spousal living and resource allowances are deducted. According to federal and state laws to prevent
spousal impoverishment, the non-applicant may receive up to $3,160.50 of their spouse’s monthly income and retain up to $126,420 in joint assets. These rules only apply to seniors seeking Medi-Cal for long-term care in a nursing home or through a home and community-based waiver.
Placerville seniors can
apply for Medi-Cal coverage online, in person at the local
Health and Human Services office located at 3057 Briw Road or by calling (800) 300-1506.
Assisted Living Waiver Medi-Cal introduced the
assisted living waiver program to give seniors the option of residing in community-based assisted living facilities and reduce the number of nursing home admissions. The program is only available in 15 counties statewide, including adjacent Sacramento County. Placerville residents can apply for the ALW if they’re willing to relocate, are aged 21 or older and:
- Eligible for full-scope Medi-Cal coverage with no share of cost
- Have been assessed as needing a nursing home level of care
- Deemed cognitively and physically capable of living in the community without any safety concerns
Participants in the program must pay their own assisted living room-and-board fees, but the waiver covers a number of facility-provided services, including:
- Transition assistance to relocate from a nursing home
- Care coordination and social services
- Oversight of medication administration
- Periodic skilled nursing care
- Meals and snacks
- Laundry and housekeeping services
- Help with daily living activities and personal care
- Recreational and social activities
- Transportation
To learn more about the ALW or begin the application process, Placerville seniors can contact
Elder Options, the local approved
Care Coordination Agency, at (530) 626-6939.