One in four California residents receive health care coverage through Medicaid, the federal and state-funded program that operates from coast to coast to provide low-income Americans with affordable health insurance. The state program called Medi-Cal primarily serves pregnant women, families with dependent children, blind and disabled adults and the elderly.
Qualifying for Medi-Cal as a Senior
Vallejo seniors aged 65 or older can qualify for full-scope Medi-Cal benefits if they have:
- No more than $1,242 in monthly income and $2,000 in countable resources if single
- No more than $1,682 in monthly income and $3,000 in combined countable resources if married and applying with a spouse
Seniors and disabled adults who receive
Supplemental Security Income benefits automatically qualify for full-scope Medi-Cal coverage. Those assessed with a functional or medical need for nursing home care qualify for coverage at any income level, provided they meet the appropriate resource limit.
Qualifying Through a Share of Cost Seniors who exceed the income limit may be able to reach the eligibility threshold using a
share of cost, which involves using their monthly over-limit income to pay for approved medical and care expenses.
Qualifying After Spousal Allowance Deductions A married applicant who exceeds the income and resource limits but whose spouse doesn’t need coverage may qualify after federally mandated
spousal allowances are calculated. These can reduce the applicant’s income by up to $3,160.50 per month and lower their countable resources by up to $126,420.
Vallejo seniors in need of Medi-Cal coverage can
apply online or call Covered California at (800) 300-1506.
Medi-Cal HCBS Assisted Living Waiver Seniors in Vallejo who are eligible for long-term care coverage through Medi-Cal but want to avoid admission to an institutional nursing home can apply for the
Assisted Living Waiver program. The goal of this Home and Community-Based Services waiver is to reduce the state’s overall cost for long-term care while providing seniors with greater independence and a higher quality of life.
To enroll in the ALW program, Vallejo residents must be aged 21 and older and:
- Eligible for full-scope Medi-Cal coverage with zero share of cost
- Need the level of care normally provided in a nursing home but be able to live in an assisted living setting without any safety issues
The ALW doesn’t pay for room and board, but it does cover various support services provided by an assisted living facility, such as:
- Transitional aid to relocate back to the community from a nursing home
- Care coordination
- Social services
- Housekeeping and laundry
- Personal care
- Assistance with daily living activities
- Social and recreational programs
- Prepared meals and snacks
- Supervision of medication administration
- Transportation services
Although Solano County doesn’t participate in the ALW program, Vallejo seniors can still apply if they’re willing to relocate. Participating counties include Sacramento, Contra Costa, Sonoma and 12 others throughout the state. It also should be noted that the ALW isn’t a Medi-Cal entitlement program, and it’s available at a limited number of licensed
assisted living facilities, so eligible seniors may be placed on a waiting list until space becomes available.
To learn more about the ALW or apply, Vallejo seniors should contact a Medi-Cal approved
Care Coordination Agency in their preferred county.