As people age, access to affordable and comprehensive healthcare becomes more important than ever. In California, seniors aged 65 and over may qualify for Medi-Cal, the state’s Medicaid program, which offers vital healthcare services to eligible low-income residents. Understanding how Medi-Cal works, who qualifies, and what benefits it provides can empower seniors and their families to make informed decisions about their health coverage.
Understanding Medi-Cal
Medi-Cal is California’s version of the federal Medicaid program. It is designed to provide health care services to individuals and families with limited income and resources. The program is administered by the California Department of Health Care Services (DHCS) and funded jointly by the state and federal governments.
Medi-Cal is available to a variety of groups, including:
- Low-income families
- People with disabilities
- Pregnant individuals
- Children and young adults
- Seniors aged 65 and older
Medi-Cal for Seniors Over 65: Who Qualifies?
Seniors over 65 may qualify for Medi-Cal based on income and asset limits, disability status, or dual eligibility with Medicare. Eligibility criteria include:
1. Income Limits
Income thresholds vary depending on the Medi-Cal program category. For example, under the Aged & Disabled Federal Poverty Level (A&D FPL) program, seniors must have:
- Monthly income at or below $1,732 for individuals or $2,351 for couples (2024 figures; subject to change annually).
2. Asset Limits
As of January 1, 2024, asset limits have been eliminated for most Medi-Cal programs for seniors. This means that assets such as savings, property (excluding the primary residence), and other resources are no longer considered in determining eligibility. This is a significant change that has expanded access for many older adults.
3. Dual Eligibility with Medicare
Many seniors qualify for both Medicare and Medi-Cal, known as dual eligibility. In this case, Medicare acts as the primary insurer, and Medi-Cal helps cover Medicare premiums, deductibles, and co-payments, along with services not covered by Medicare.
Key Benefits of Medi-Cal for Seniors
Medi-Cal provides a wide range of health benefits that support the diverse needs of seniors:
- Doctor visits and hospital care
- Prescription drugs
- Laboratory and X-ray services
- Home health care
- Skilled nursing facilities
- Vision and dental care
- Mental health and substance use disorder services
- Medical transportation
- In-Home Supportive Services (IHSS)
For those with long-term care needs, Medi-Cal is one of the few programs that covers nursing home care and other long-term services and supports (LTSS).
How to Apply
Seniors can apply for Medi-Cal in several ways:
- Online at BenefitsCal.com
- By mail through their local county social services office
- In person at a county office
- With the help of a certified enrollment counselor or health navigator
Applications are reviewed by the local county office, and eligibility is usually determined within 45 days.
Final Thoughts
Medi-Cal is a lifeline for many seniors in California, offering access to affordable healthcare services that support healthy aging. Whether used alone or in combination with Medicare, it ensures that individuals over 65 can get the medical care they need without excessive financial burden.
If you or a loved one is approaching age 65, it’s wise to explore Medi-Cal eligibility early and seek help if needed to navigate the application process. With recent changes like the elimination of asset limits, more seniors than ever are able to access the care they deserve.