Medicaid is a public health insurance program that provides health benefits to eligible low-income people. California’s Medicaid program, which is called Medi-Cal, covers a variety of comprehensive services. These include emergency services, hospitalization, physical therapy, preventative services and mental health services. Medi-Cal may also provide coverage for long-term care, including personal care and community-based services.
To be eligible for Medi-Cal coverage, seniors must:
- Be a resident of California
- Be a U.S. citizen, U.S. national, permanent resident or legal alien
- Be 65 years of age, blind or disabled
- Earn less than $16,146 per year ($21,892 for couples)
- Have less than $2,000 in countable assets ($3,000 for couples)
Countable assets refer to certain types of liquid assets, such as your bank balances or stock portfolios. The primary residence, one car, clothing, household items and recreation items are excluded. Real estate and personal property that’s used for business is also excluded.
To apply for Medi-Cal coverage, California residents can fill out an application on the
Covered California website or call (800) 300-1506 to speak with a representative. Seniors who prefer to apply in person can visit their local
Department of Health and Human Services office.
Assisted Living Waiver Program This home- and community-based services waiver provides services to seniors who live in assisted living facilities and the community. The
Assisted Living Waiver program does not cover room-and-board costs. Covered
services may include:
- Personal care services
- Assistance with daily activities, such as bathing or feeding
- Help with laundry and housekeeping
- Medication assistance
- Transportation assistance
In addition, participants may have access to
two other waiver benefits: Care Coordination and Nursing Facility Transition Care Coordination. The former develops individualized service plans for seniors and arranges for them to receive necessary services. The service delivery is monitored monthly. The latter waiver benefit helps seniors who live in nursing facilities transition back into the community. This may include a transition to an assisted living facility.
To participate in this waiver program, seniors must be eligible for full Medi-Cal coverage. They must have a verified need for the level of care that’s provided in nursing homes but be willing and able to live in an assisted living facility. Seniors must also receive assisted living care in a county that supports the waiver. While Marin County doesn’t offer the waiver at this time, San Rafael seniors can receive services in nearby counties, including Contra Costa, San Francisco, Santa Mateo and Sonoma.
To apply for this program, Medi-Cal members can contact the
Care Coordination Agency (CCA) that serves the county where they would like to receive services. The CCA conducts an assessment and determines a senior’s care needs.
Multipurpose Senior Service Program The Multipurpose Senior Service Program (MSSP) helps prevent or delay individuals from moving into a nursing facility. The waiver program provides community services to help seniors remain in their own homes or in an assisted living facility. Some of the services provided through this program include personal care assistance, care management and meal services.
To be eligible for this program, seniors must:
- Be 65 years of age or older
- Be eligible for Medi-Cal
- Need a nursing home level of care
- Live within the service area of a MSSP site
Marin County’s MSSP site is operated by
Jewish Family and Children’s Services. To receive an assessment, seniors can call this agency at (415) 491-7960. A maximum of 11,789 seniors can be served through MSSP each month, so there may be a waiting list to receive services.