Medi-Cal
According to the California Department of Health Care Services (DHHS) Medi-Cal qualification website, a family of two can qualify for Medi-Cal if their annual income is below 138% of the federal poverty level which is $22,108 (California Department of Health Care Services, 2016). An individual can also qualify for Medi-Cal if they 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 on how long they have been in the United States; breast cancer cervical cancer patients who qualify under the Breast and Cervical Cancer Treatment Program (California Department of Health Care Services, 2016); and/or a parent or caretaker relative of a child under 21 if the child's parent is deceased or doesn't live with the child, or the child's parent is incapacitated, or the child's parent is under employed or unemployed. Medi-Cal is also available to individuals who are enrolled in CalFresh, SSI/SSP, CalWorks (AFDC), Refugee Assistance, and/or the Foster Care or Adoption Assistance Program.
Applications for Medi-Cal can be made on the Covered California website (Covered California, 2016). Applications may also be filed in person at local county human services agencies (California Department of Health Care Services, 2016). Covered California gives a description of who’s eligible for Medi-Cal on their website that concisely summarizes the verbiage on the DHHS site: “Medi-Cal covers low-income adults, families with children, seniors, persons with disabilities, children in foster care as well as former foster youth up to age 26, and pregnant women” (Covered California, 2016).
According to California Health Advocates, the male spouse in the case would be considered for Medi-Cal under the Medi-Cal for individuals with Medicare program known as “dual eligibles” or “Medi-Medis” because he is 72 years of age (California Health Advocates, 2016). For a couple, the asset limitation is $3000 excluding the primary home, one vehicle, household goods and personal belongings, a life-insurance policy with a face value of $1,500 per person, a prepaid burial plan (unlimited if irrevocable or up to $1,500 if revocable) and burial plot. Various Medi-Cal programs are available to Medicare eligible individuals as shown in the table below from California Health Advocates (California Health Advocates, 2016).
Medi-Cal Programs – Qualification at a Glance
(Asset limits are the same for all programs: Single: $2,000; Couple: $3,000)
Program / Requirements
Your Monthly Income
Supplemental Security Income (SSI)
· 65 or older, blind or disabled
Single: up to $889.40/mo.
Couple: up to $1,496.20/mo.
Note: Higher income levels apply for individuals who are blind.
Aged & Disabled Federal Poverty Level (A&D FPL) Program
· 65 or older, blind or disabled
Single: up to $1,220/mo.
Couple: up to $1,645/mo.
Medi-Cal with a Share of Cost (SOC)
· 65 or older, blind or disabled
Single: over $1 ...
Medi-Cal According to the California Department of Health Care.docx
1. Medi-Cal
According to the California Department of Health Care Services
(DHHS) Medi-Cal qualification website, a family of two can
qualify for Medi-Cal if their annual income is below 138% of
the federal poverty level which is $22,108 (California
Department of Health Care Services, 2016). An individual can
also qualify for Medi-Cal if they 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 on how long they have been in the United States;
breast cancer cervical cancer patients who qualify under the
Breast and Cervical Cancer Treatment Program (California
Department of Health Care Services, 2016); and/or a parent or
caretaker relative of a child under 21 if the child's parent is
deceased or doesn't live with the child, or the child's parent is
incapacitated, or the child's parent is under employed or
unemployed. Medi-Cal is also available to individuals who are
enrolled in CalFresh, SSI/SSP, CalWorks (AFDC), Refugee
Assistance, and/or the Foster Care or Adoption Assistance
Program.
Applications for Medi-Cal can be made on the Covered
California website (Covered California, 2016). Applications
may also be filed in person at local county human services
agencies (California Department of Health Care Services,
2016). Covered California gives a description of who’s eligible
for Medi-Cal on their website that concisely summarizes the
verbiage on the DHHS site: “Medi-Cal covers low-income
adults, families with children, seniors, persons with disabilities,
children in foster care as well as former foster youth up to age
26, and pregnant women” (Covered California, 2016).
According to California Health Advocates, the male spouse in
the case would be considered for Medi-Cal under the Medi-Cal
2. for individuals with Medicare program known as “dual
eligibles” or “Medi-Medis” because he is 72 years of
age (California Health Advocates, 2016). For a couple, the asset
limitation is $3000 excluding the primary home, one vehicle,
household goods and personal belongings, a life-insurance
policy with a face value of $1,500 per person, a prepaid burial
plan (unlimited if irrevocable or up to $1,500 if revocable) and
burial plot. Various Medi-Cal programs are available to
Medicare eligible individuals as shown in the table below from
California Health Advocates (California Health Advocates,
2016).
Medi-Cal Programs – Qualification at a Glance
(Asset limits are the same for all programs: Single: $2,000;
Couple: $3,000)
Program / Requirements
Your Monthly Income
Supplemental Security Income (SSI)
· 65 or older, blind or disabled
Single: up to $889.40/mo.
Couple: up to $1,496.20/mo.
Note: Higher income levels apply for individuals who are blind.
Aged & Disabled Federal Poverty Level (A&D FPL) Program
· 65 or older, blind or disabled
Single: up to $1,220/mo.
Couple: up to $1,645/mo.
Medi-Cal with a Share of Cost (SOC)
· 65 or older, blind or disabled
Single: over $1,220/mo.
Couple: over $1,645/mo.
250% California Working Disabled (CWD)
· Have work
· Meet Social Security’s definition of disability
· Pay small monthly premium
Single: up to $2,475/mo.
Couple: up to $3,338/mo. Note: Income excludes disability
benefits
3. Medi-Cal benefits include coverage for healthcare that is
deemed "medically necessary". Coverage includes lab tests,
imaging examinations, provider visits, home nursing care,
hospitalization, home healthcare, prescription drugs under
Medicare part D (in this case), hearing aids, ambulance
services, hospice care, medical equipment, and prosthetics. In
addition to these benefits the California Department of Health
Care Services specifically lists outpatient (ambulatory) services,
emergency services, maternity and newborn care, mental health
and substance use disorder services including behavioral health
treatment, physical and occupational therapy, preventive and
wellness services, and chronic disease management (California
Department of Health Care Services, 2016). Medi-Cal covers
costs only if the enrollee uses facilities and providers that
accept Medi-Cal (California Health Advocates, 2016).
In this case, the couple is looking for “home care services, an
adult day health program, or the possibility of nursing home
care.” According to California Health Advocates and DHHS, as
per the list above, all of these services are covered by Medi-Cal.
In my search for information, I relied on the California
Department of Health Care Services, Covered California, and
California Health Advocates website pages as listed in the
bibliography. As a departmental chairman at our academic
medical center and as vice president of the medical group I have
a significant amount of healthcare literacy. Even so, I found it
fairly difficult to navigate the sites, and it took quite a bit of
time to ferret out the specific information that I was looking
for. Based on this experience I think the sites would be fairly
difficult to use for someone with a low level of healthcare
literacy. I think the sites would also prove difficult to use for
individuals with a visual impairment. Because my eyesight is
much worse on the left than on the right, I was able to check
this myself. I tried navigating the sites using my left eye only,
and this proved to be impossible. Regarding individuals with
4. arthritis or other disabilities that limit hand functionality, the
number of clicks required to find information on the sites would
prove difficult. Short-term memory loss would also be
challenging as I found in navigating the sites that it was useful
to be able to recall where I had seen a particular piece of
information. If I did not have these memories at my disposal, I
would have to start from scratch with each query.
Bibliography
California Department of Health Care Services. (2016). Breast
and Cervical Cancer Treatment Program. Retrieved June 15,
2016, from California Department of Health Care Services:
http://www.dhcs.ca.gov/services/medi-cal/Pages/BCCTP.aspx
California Department of Health Care Services. (2016). County
Offices to Apply for Health Coverage, Medi-Cal, and Other
Benefits. Retrieved June 15, 2016, from California Department
of Health Care Services: http://www.dhcs.ca.gov/services/medi-
cal/Pages/CountyOffices.aspx
California Department of Health Care Services. (2016). Medi-
Cal Eligibility. Retrieved June 15, 2016, from California
Department of Health Care Services:
http://www.dhcs.ca.gov/services/medi-
cal/Pages/DoYouQualifyForMedi-Cal.aspx
California Department of Health Care Services. (2016). What
are the Medi-Cal Benefits? Retrieved June 15, 2016, from
California Department of Health Care Services:
http://www.dhcs.ca.gov/services/medi-cal/Pages/Medi-
Cal_EHB_Benefits.aspx
California Health Advocates. (2016). Medi-Cal (for People with
Medicare). Retrieved June 15, 2016, from California Health
Advocates: http://www.cahealthadvocates.org/low-income/medi-
cal.html#qualify
Covered California. (2016). How to Apply. Retrieved June 15,
2016, from Covered California:
http://www.coveredca.com/apply/
Covered California. (2016). Medi-Cal. Retrieved June 15, 2016,
from Covered California: http://www.coveredca.com/medi-cal/
5. 1. Explain how GDP deflator and CPI measures of inflation are
calculated and discuss the difference between them.
2. The government lowers taxes by $30. The marginal
propensity to consume is 0.60. Using the national income
identity Y = C(Y-T) + I(r) + G, determine the impact of the tax
cut on the following? Do they rise or fall? By what amount?
a. Consumption
b. Private saving
c. Public saving
d. Investment
e. Interest rate.
3. Define marginal product of factors K and L in the production
function Y = F (K, L).
If the factors are paid according to their marginal product, the
economic profit is zero when the production function has the
property of constant returns to scale. Explain this statement.
Does this mean profit does not exist in the economy?
4. In quantity theory of money model, MV = PY, assume that V
is constant, M is growing at 6% per year, Y is growing at 3%.
a. If r = 2, what is i?
b. If the Fed reduces the money growth rate by 2% points per
year, what would be effect on i, given r = 2?
c. If the growth rate of Y increases to 5% per year, what would
be the effect on inflation? Interest rate?
5. The money supply and money demand functions of an
economy are as follows:
Money supply: (M/P)s
Money demand: (M/P)d = L (i, Y) = 0.2Y/0.5i
a. What is the velocity of money in this economy?
b. If output is 1000 units, i is 4 percent and money supply M is
6. $1,200, what is the price level P?
c. If money supply increases by 5%, what will be the impact on
price level if the output increases by 2% and the interest rate
remains constant?
d. If money supply increases by 5%, what will be the impact on
price level if the output increases by 2%, interest rate by 1%?
Week 5 DB:Medicaid Eligibility
Imagine a close friend asked for your help. You are to research
information about health insurance for this close friend. She is
62 years old and her husband is 72 years old. He is in a rehab
hospital following what she calls a "mild stroke". Your friend
is employed on a part-time basis as a waitress at a local coffee
shop. Determine if they qualify for Medicaid in your state.
Locate an official government on-line source of information for
the state you consider “home” (you might live there or it might
be home to your family members). Find an additional source of
insurance information from an advocacy or resource group for
your state. To help determine eligibility, take a look at the
current Federal Poverty (FPL) Guidelines. (Remember to
identify your home state and include a link to your resource
sites.)
A. 1. a.What are the eligibility requirements for Medicaid in
your state? Are they both eligible for Medicaid in your state?
b. How much income (Social Security, wages, pension,
interest, etc.) is allowed each month (as a Medicaid
beneficiary)?
c. How much assets are they allowed? Which
7. possessions count as assets?
2. Assuming eligibility, what benefits are available?
Provide an overview of the assistance programs specific to their
needs. She is considering home care services, an adult day
health program, or the possibility of nursing home care.
B. Share your thoughts:
1. Are the sites user-friendly? Consider health care literacy
standards. Also contemplate getting the information if you had
an age-related limitation such as poor vision, limited hand
function due to arthritis, or short term memory loss.