Low-income and disabled people across the country benefit from Medicaid programs that provide essential health care services. Seniors in California who qualify through Medi-Cal can receive Medicaid services funded by the state and federal governments.
Medi-Cal pays for various medical services, such as doctors appointments, prescriptions, hospitalization, surgery, emergency and dental services, medical supplies and transportation. Some ongoing care is also covered, including in-home support services, temporary nursing facility stays and adult day health care. Assisted living is not covered by regular Medi-Cal, but a Medicaid waiver shown below offers a possible solution.
Medi-Cal has close to 100 care categories with varying eligibility requirements based on the status and needs of the applicant. To qualify, applicants must be at least 65 years of age, disabled or blind. Applicants must also be a legal resident of California and meet income and asset guidelines. As of 2019, the income limit is $1,436 a month. The asset limit is $2,000, excluding a personal home and vehicle along with other non-countable assets.
Depending on the care category, an individual may qualify for partial or full coverage and receive some or all of the services Medicaid offers. Seniors who qualify for Supplemental Security Income automatically receive full coverage with no share of cost.
To apply for Medi-Cal, visit Covered California and submit the required information or call (800) 300-1506. Alternatively, applicants can request free assistance from certified enrollers in their local area.
Medi-Cal Assisted Living Waiver Program
Federal regulations restrict Medicaid programs such as Medi-Cal from paying for assisted living room-and-board costs. However, California’s Assisted Living waiver program does pay for a number of related expenses, including:
- Help with activities of daily living
- Medication management and administration
- Social/recreational activities
- Laundry, housekeeping and meals
- Skilled nursing services
This waiver is available in most areas of the state, although Ventura County is not currently a participant. Individuals who would otherwise qualify may find relocating to a participating county worthwhile.
To be eligible for the waiver, applicants must be approved for full Medi-Cal coverage with no share of cost and be assessed by a registered nurse from a local Care Coordination Agency to determine if they qualify medically.
To apply for the Assisted Living Waiver program, contact a nearby
Care Coordination Agency to request an assessment.