Medicaid is a public health insurance program that helps low-income Americans pay for the medical care they need. Across the country, over 65.5 million people rely on Medicaid for health coverage, and about 10.5 million of them are in California. These people include seniors, children, pregnant women and other eligible groups.
In California, Medicaid is known as Medi-Cal. Some of the health benefits offered through this program include physician services, inpatient and outpatient hospital services, emergency services, mental health services and preventative services.
People who are 64 or older may qualify for Medi-Cal if they are California residents with low incomes. The yearly income cut-off is $16,612 ($22,491 for couples). In addition, there is an asset limit to receive Medi-Cal. For individuals, the limit is $2,000, and for couples, it’s $3,000. The state doesn’t count some necessary assets, such as a primary residence or one car, toward this limit.
The Share of Cost program may help people who earn more than the Medi-Cal income limit pay for their health care needs. Each month, participants take full responsibility for a predetermined amount of medical costs, and once they pay that amount, Medi-Cal kicks in for the rest of the month.
Visit the Covered California website to quickly apply for Medi-Cal coverage. To apply over the phone, call the Covered California Service Center at (800) 300-1506.
In-person applications are accepted at any enrollment center listed in the Covered California Storefront Finder. Sonoma residents will notice many centers in nearby Napa, including the OLE Health Clinic, located at 1141 Pear Tree Ln., Napa, CA 94558. Seniors can call this center at (707) 254-1777.
Applicants should be prepared to provide their income and federal tax information. Noncitizens need to show their immigration documents, while citizens need their Social Security numbers.
For more information about Medi-Cal, call (800) 300-1506 to speak with a Covered California representative.
Assisted Living Waiver
This home and community-based services waiver is available in several California counties, including Sonoma County. Through the Assisted Living waiver, seniors receive services in their homes or in assisted living facilities, which helps them stay out of nursing homes.
One of the waiver’s benefits is care coordination. Seniors receive individualized service plans then a care coordinator helps them access the care they need. Another advantage is nursing facility transition care coordination, which helps seniors in nursing homes move back into an assisted living setting. The third waiver benefit is assisted living services. Seniors can access a number of services through this benefit, including personal care, housekeeping and skilled nursing.
Seniors may be able to participate in this program if they:
- Are eligible for Medi-Cal with no spend-down requirement
- Need the same amount of care as Medi-Cal-funded nursing home residents
- Can safely live in an assisted living facility
- Are willing to live in an assisted living setting instead of in a nursing home
Care Coordination Agencies provide ALW services and handle all enrollments for the program. Medi-Cal members who are interested in this waiver can contact one of the
CCAs that serves their county.
The NorCal Care Coordination Agency, located in Citrus Heights, is the closest CCA for Sonoma residents. To set up an assessment or to learn more about the program, call this provider at (916) 385-2784.
Seniors should note that the ALW program is not an entitlement. CCAs add eligible seniors to the program’s
waiting list.