Medi-Cal According To The California Department Of Health Ca

Medi Calaccording To The California Department Of Health Care Services

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

Coverage includes lab tests, imaging examinations, provider visits, home nursing care, hospitalization, home healthcare, prescription drugs under Medicare part D, hearing aids, ambulance services, hospice care, medical equipment, and prosthetics. Additional benefits include outpatient services, emergency services, maternity and newborn care, mental health and substance use disorder services, 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 considering “home care services, an adult day health program, or the possibility of nursing home care.” All of these services are covered by Medi-Cal according to California Health Advocates and DHHS. Nonetheless, navigating the sites to find specific information proved challenging even for someone with healthcare literacy and good familiarity with medical systems. This difficulty could be exacerbated for individuals with low health literacy, visual impairments, arthritis, or memory issues, due to the complexity, navigation demands, and accessibility limitations of the websites.

Paper For Above instruction

Medi Calaccording To The California Department Of Health Care Services

Medi-Cal, as outlined by the California Department of Health Care Services (DHHS), is California’s Medicaid program that provides health coverage to low-income individuals and families. The program’s eligibility criteria, coverage options, and application processes have been designed to serve a broad demographic, but navigating the relevant resources can be challenging for some populations due to website complexity and accessibility barriers.

Eligibility for Medi-Cal varies depending on various factors such as income, age, disability status, pregnancy, and specific health conditions. For example, a family of two can qualify if their annual income is below 138% of the federal poverty level (FPL), approximately $22,108 per year (California Department of Health Care Services, 2016). Other groups eligible include individuals aged 65 or older, those who are blind or disabled, pregnant women, and children under 21. Some specific conditions like refugee status or certain cancer diagnoses also qualify individuals. Additionally, parents or caregivers of children under 21 may qualify based on their relationship and the child’s circumstances.

Furthermore, Medi-Cal extends to persons enrolled in assistance programs like CalFresh, SSI/SSP, CalWORKs, Refugee Assistance, or Foster Care. Applications can be submitted via the Covered California website or in person at local county human services agencies. Covered California emphasizes that Medi-Cal covers a wide range of services including healthcare deemed medically necessary such as provider visits, hospital stays, prescription drugs (including Medicare Part D), laboratory and imaging tests, mental health services, maternity care, and preventive services (Covered California, 2016). This comprehensive coverage demonstrates the program’s commitment to holistic care for vulnerable populations.

For individuals aged 72, such as the male spouse in the hypothetical case, California Health Advocates notes that they may qualify under the “dual eligibles” or “Medi-Medis” program if they are enrolled in Medicare. The asset limit for couples is set at $3,000, excluding primary residence, one vehicle, personal belongings, a life insurance policy valued up to $1,500 per person, and burial arrangements. Several specific Medi-Cal programs exist to assist Medicare-eligible elders, with eligibility often depending on income and assets. These programs' requirements encompass various income thresholds, with monthly income limits specified for different categories, such as the Supplemental Security Income (SSI) and Aged & Disabled Poverty Level programs (California Health Advocates, 2016).

Coverage under these programs includes essential medical services: hospital care, outpatient treatments, mental health services, physical therapy, prescription drugs, dental, hearing aids, and long-term care options such as home care and nursing home care. These services are vital for aging populations, especially those recovering from medical events like strokes, which can severely affect functional independence.

Despite the breadth of information available, users often face difficulties navigating the official websites like California’s DHHS and Covered California. As an individual with healthcare literacy and professional familiarity, I found the sites complex, requiring significant time to locate specific details, especially regarding eligibility, income thresholds, and application procedures. This complexity can be a barrier for individuals with limited literacy, disabilities, or age-related limitations such as visual impairments or arthritis, which can limit manual dexterity required for navigating online platforms. Furthermore, individuals with memory issues may struggle to recall where they have previously seen relevant information, compounding access problems.

Altogether, while Medi-Cal provides critical health services to California’s low-income and vulnerable populations, the accessibility of information and ease of navigation remain essential factors influencing enrollment and continued participation. Improving website design to enhance user-friendliness, accessibility for individuals with disabilities, and simplified pathways for application could substantially benefit those whom the system aims to serve. As policymakers and service providers endeavor to expand health coverage and address social determinants of health, addressing these digital barriers is crucial for ensuring equitable access.

References

• California Department of Health Care Services. (2016). Breast and Cervical Cancer Treatment Program. Retrieved June 15, 2016, from https://www.dhcs.ca.gov/services/cancer/Pages/default.aspx
• California Department of Health Care Services. (2016). County Offices to Apply for Health Coverage, Medi-Cal, and Other Benefits. https://www.dhcs.ca.gov/services/Pages/CountyOffices.aspx
• California Department of Health Care Services. (2016). Medi-Cal Eligibility. https://www.dhcs.ca.gov/services/Pages/Eligibility.aspx
• California Department of Health Care Services. (2016). What are the Medi-Cal Benefits? https://www.dhcs.ca.gov/services/Pages/MediCalBenefits.aspx
• California Health Advocates. (2016). Medi-Cal (for People with Medicare). https://cahealthadvocates.org/medi-cal/
• Covered California. (2016). How to Apply. https://www.coveredca.com/apply/
• Covered California. (2016). Medi-Cal. https://www.coveredca.com/medi-cal/
• Centers for Medicare & Medicaid Services. (2022). Medicaid & CHIP Eligibility & Enrollment. https://www.medicaid.gov/medicaid/eligibility/index.html
• National Institute on Aging. (2020). Aging and Disability Resources. https://www.nia.nih.gov/health/aging-and-disability-resources
• U.S. Department of Health & Human Services. (2021). Title VI of the Civil Rights Act of 1964 - Accessibility and Discrimination. https://www.hhs.gov/civil-rights/for-individuals/special-topics/accessibility/index.html