For low-income residents of California, health care costs became less of a concern on this year, when on Jan. 1, the state rolled out its final phase of Medi-Cal expansion, providing free health care to all residents, regardless of immigration status.
Also beginning Jan. 1, Medi-Cal eligibility will be based solely on income. Assets are not included, which means a person can own a home, a car, even a stock portfolio, and still be eligible for benefits, explained Yingjia Huang, Assistant Deputy Director at California Department of Health Care Services.
“Those are considered assets that no longer need to be verified, or included in the basis of the determination,” she explained in an interview.
People living on retirement or pension benefits of under $1,732 per month would qualify for Medi-Cal, Huang clarified.
Living With Family
Adriene Clark, client advocate at the Alameda County Department of Social Services, noted that retired seniors who choose to live with their family are still eligible for expanded Medi-Cal, as eligibility is determined solely on their income, not the income of the household in which they live. This is an enormous benefit to multi-generational families living in the same household.
Medi-Cal applicants can even keep assets they might have in the home country if they are immigrants, she said, noting such assets will not be included in eligibility determination.
Stock portfolios can also be kept, but dividends and payouts from stock would be counted as income.
Proof of Immigration Status Not Required
“More people will be able to see health care providers when they need to, which will reduce sickness and guarantee more wellness throughout the state,” said Clark.
California is the first state in the nation to provide health care coverage to undocumented residents. No proof of immigration status is required to enroll.
The expansion provides a huge boon to seniors living in California. More than 600,000 people in the state who are over the age of 65 live below the federal poverty line of $15,000 per year.
Poverty is especially acute among undocumented immigrants: about 27% live below the federal poverty line, according to the Public Policy Institute of California.
Older Adult Expansion Program
Seniors can provide proof of California residency via a utility bill or a rental agreement; there is no requirement as to how long they have lived in California.
Applicants must also be able to provide proof of income, and vouch that they intend to stay in California indefinitely. Additional eligibility requirements for the Medi-Cal Older Adult Expansion Program can be found here.
Medi-Cal expansion for seniors has been in effect since May 1, 2022. This January brought about the final phase of expansion, which now includes all low-income residents of the state.
Benefits
“In California, we believe everyone deserves access to quality, affordable health care coverage – regardless of income or immigration status,” California Governor Gavin Newsom said when signing the bill in 2021. “Through this expansion, we’re making sure families and communities across California are healthier, stronger, and able to get the care they need when they need it.”
Full-scope Medi-Cal includes a variety of services, including: routine and emergency health visits, medication and medical supplies, including hearing aids, personal attendant care, referrals to specialists, and even transportation to and from doctors and pharmacy visits.
More recently, the California Department of Health Care Services, which oversees Medi-Cal, has attempted to avoid the stigma surrounding mental health care by pairing it with programs such as free accupressure and Qigong classes. One out of 5 Asian Americans need mental health services, but fewer than 1 in 50 seek it out. The reluctance to seek mental health care is especially acute among older Asian adults.
Assisted Living
Medi-Cal will not pay for room and board at an assisted living facility, but will pay for services rendered at the facility, explained Joseph Billingsley, Assistant Deputy Director, Integrated Systems of Care, Health Care Delivery Systems at DHCS. Those who need assisted living facilities would have to find a means to pay for their room and board. Assisted living waivers are available through the state to help with room and board costs, but are currently only available in 15 counties, Billingsley said in an interview.
Folks who qualify for an assisted living waiver must use one of the assisted living facilities that have been approved by the state. Those approved facilities are called Residential Care Facilities for the Elderly, and are equipped to take Medi-Cal. Residents, however, may still find that they have to pay for some of their room and board, even with a waiver.
Medi-Cal does offer some services for older people who choose to age in their homes.
A modified version of this story also appears in India Currents.