Monday, 04 March 2024

Make too much for Medi-Cal? Maybe not

LAKE COUNTY, Calif. – On a regular basis, Community Care’s Senior Information & Assistance call line hears from older adults in need of basic home chore help, dentistry, lower prescription costs and more.

These individuals have applied for Medi-Cal for help and have come away from the application process with the understanding that they are over income for Medi-Cal supports.

Although they may be eligible on the low-asset front, they are not eligible on the low-income front.

That’s because their monthly income exceeds $1,270 as an individual ($1,719 for couples) and they would have to incur a large monthly deductible “Share of Cost” before Medi-Cal would kick in to help with the costs of their essential needs.

Sometimes that’s the reality; other times, by learning more, an older adult can take action to become eligible for no-share-of-cost Medi-Cal and the help it provides.

When these calls come in, Senior Information & Assistance has learned to ask: “What’s your gross income before insurance-related deductions and are you paying for supplemental insurance?” and “Were you on Social Security Disability prior to retiring?”

When reviewing some callers’ information, we discuss that by purchasing supplemental medical, dental, or vision insurance, they can reduce their countable income to fall within the eligibility limits.

This allows them to not only enjoy all the wider benefits of no-share-of-cost Medi-Cal, but also be reimbursed for the Medicare Part B premium being deducted from their Social Security deposits each month.

For others – who were drawing Social Security Disability leading up to retirement age – we discuss whether there is some small, verifiable employment they are engaged in or could be engaged in (pet sitting, mending, tutoring – as little as two hours a month).

If so, then that might open the door for them to participate in no-share-of-cost Medi-Cal by paying a monthly premium as low as $20, depending on the amount of their earned income.

These modest actions can sometimes lead to big improvements in these individuals’ lives. To learn more, contact Community Care’s Senior Information & Assistance line at 468-5132 to request a fact sheet with details and examples prepared by the non-profit legal advocacy group at CANHR.org, or link to it here.

Funded largely through the Area Agency on Aging of Lake & Mendocino Counties, Community Care’s Senior Information & Assistance Program is available Monday through Friday to respond to questions about resources for area older adults.

Call 707-468-5132 or 1-800-510-2020, or visit www.SeniorResourceDirectory.org.

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