What Is Medi-Cal? Who Provides These Benefits?

Medi-Cal is government assistance for any medically necessary treatment or care that a person cannot afford to provide for themselves. It is provided by the state of California administering a federal program. In the other 49 states, it is called Medicaid. In California, we have chosen to take the money that the federal government allocates for Medicaid and set up our own system that we call Medi-Cal.

Are There Any Differences Between Medi-Cal and Medicare?

There are a lot of differences between Medi-Cal and Medicare. Medicare is a program that everyone pays into while they are working as part of their Social Security contribution. It is more of an insurance than a government benefit. People who have worked and paid into the system are entitled to receive Medicare benefits upon reaching retirement age, whether or not they have the assets to pay for them themselves.

Who Is Eligible For Medi-Cal?

Medi-Cal is based on a person’s need and so the qualifications have to do with the amount of assets the person has and the person’s income level. For income, it is essentially if you are below 138 percent of poverty level. For assets, you must only have $2,000 or less in non-exempt assets.

Does Medi-Cal Cover Nursing Home Costs?

Medi-Cal will cover nursing home costs as long as the nursing home is medically necessary as determined by a doctor.

Does Medi-Cal Cover Assisted Living Housing?

Medi-Cal covers assisted living housing in limited circumstances. These would be patients who would qualify for Medi-Cal and need nursing home care but could also make do with living in an assisted living situation where they do not need full nursing. In California, it is a fairly new program. There are only 3,700 available spots for this program and they are now all full. Another 2,000 spots are going to be allocated sometime later this year (2020) but there will probably still be a waiting list.

How Old Do I Have To Be For Long Term Care Medi-Cal?

Based on age, the patient has to be 65 or older for long-term care Medi-Cal but it also applies at any age if the person needing the care is blind or completely disabled.

Can I Obtain Medi-Cal Benefits Even If I Have Too Many Assets?

You generally cannot obtain medical benefits with Medi-Cal if you have too many assets. The limit on assets that a person may have is $2,000 of non-exempt assets. If your assets are more than $2,000, you may not qualify.

What Assets Are Exempt In Medi-Cal Eligibility?

The assets that are exempt in Medi-Cal eligibility and do not count toward that $2,000 limit are the person’s primary residence as long as they have stated that they wish to return to that residence. It is not important that it is likely that they would return, but just that they have a desire to return. In addition to the family residence, they also may have a vehicle. They may have life insurance. If it is a term policy then it can be any amount. If it is a whole life policy, there are limits on the value. They may have prepaid burial contracts or any insurance policy designated to pay for final burial expenses. They may have retirement assets as long as the person is receiving ongoing payments of income and principal from those retirement assets.

For more information on Medi-Cal Government Assistance In California, a free assessment of your needs is your next best step. Get the information and legal answers you are seeking by calling (626) 385-6303 today.

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