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Medi-Cal and San Diego Seniors

Thursday, June 30th, 2011 12:42 am | by San Diego Home Caregivers

We all hear about Medi-Cal but many of us may not fully understand its benefits. But for caregivers, particularly during these economic times, it is important to know exactly who can apply for this program and what is offered to those that qualify. Medi-Cal (known as Medicaid outside of California) is a public health insurance program that is financed by the state and federal government. It provides health care services for low-income individuals including families with children, seniors, persons with disabilities, foster care, and pregnant women. Medi-Cal also provides health care services to low income people with specific diseases such as tuberculosis, breast cancer or HIV/AIDS. Although Medicaid is a National program, each state sets its own guidelines regarding eligibility and services. The general premise remains the same, but certain state-specified requirements must be met in order to be eligible to receive the Medicaid benefits. In addition, the rules for counting income and resources vary from state to state and from group to group and there are special rules for those who live in nursing homes and for disabled children living at home. For those living in California, below is the Medi-Cal eligibility criteria.

Medi-Cal Eligibility Criteria:

If you're enrolled in any of the following, you can get Medi-Cal:
  • SSI (Supplemental Security Income)/SSP (State Supplemental Payment)
  • CalWorks (AFDC)
  • Refugee Assistance
  • Foster Care or Adoption Assistance Program
  • In-Home Supportive Services (IHSS)
You can also get Medi-Cal if you are:
  • 65 or older
  • Blind
  • Disabled
  • Under 21
  • Pregnant
  • In a skilled nursing or intermediate care home
  • On refugee status for a limited time, depending how long you have been in the United States
  • A parent or caretaker relative or a child under 21 if:
    • The child’s parent is deceased or doesn’t live with the child
    • The child’s parent is incapacitated
    • The child’s parent is under employed or unemployed
    • Have been screened for breast and/or cervical cancer (Breast and Cervical Cancer Treatment Program)
One of the caregiver tools we recently wrote about on The Caregiver’s Corner blog, the BenefitsCheckUp website, can help you see if you or someone you are caring for may be eligible for Medi-Cal or a variety of governmental programs. In general, you should apply for Medicaid if your income is low and you match one of the descriptions of the Eligibility Groups. Even if you are not sure whether you qualify, if you or someone in your family needs health care, it is recommended that you apply for Medicaid and have a qualified caseworker in your state evaluate your situation. For more information, visit California’s Department of Health Care Services website or call your County’s Medi-Cal office. In San Diego County, contact the Dept. of Health and Human Services Agency toll-free at 1-866-262-9881.

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