Medi-Cal and long term care coverage1
Medi-Cal pays for health care services which meet the definition of "medically neccessary." Services include: some prescriptions (although the Medicare Part D program now covers most prescriptions), physician visits, adult day health service, some dental care, ambulance services, some home health, X-ray and laboratory costs, orthopedic devices, eyeglasses, hearing aids, some medical equipment, etc.
All covered services, or the remaining costs over the share of cost of nursing home care, will be covered if the individual meets income/resource requirements. Some services such as home health care, duravle medical equipment, and some drugs require prior authorization.
Nursing home care is covered if there is prior authorization from the physician/health care provider. Residents are admitted on a doctor's order and their stay must be "medically necessary". Residents are allowed to keep $35 of their income as a personal needs allowance. Residents with no income may apply for the Supplemental Security Income/State Supplemental Program (SSI/SSP), and, if eligible, they will receive a payment of $50 as a personal needs allowance.
Covering the gap
Medi-Cal may not be an appropriate solution for you. Long term care insurance can provide more choices and gives you the flexibility to meet your long term care needs. See how Genworth can provide a comprehensive long term care insurance policy.
1 Overview of Medi-Cal for Long Term Care, California Advocates for Nursing Home Reform, February 25, 2013.
Long Term Care Insurance is underwritten by Genworth Life Insurance Company, Richmond, VA
This is a solicitation of insurance. By responding, an insurance agent will contact you. Details about the cost, benefits, limitations and exclusions of these long term care insurance policies will be provided to you by a licensed insurance agent.