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Medi-Cal, Medicare and IHSS
Not sure what Medi-Cal, Medicare and IHSS are? These complex programs (and a few others) are defined below.
The Health Insurance Counseling and Advocacy Program (HICAP) www.cahealthadvocates.org) is a great place to start if you're unsure what kind of coverage you're eligible for, if you need help filling out the paperwork, or if you want to appeal an unfavorable decision. Locally, HICAP can be reached at (510) 839-0393.
What is Medicare? www.medicare.gov
Medicare is a federal government health insurance program for people over 65 regardless of their income. It also covers younger disabled people who receive Social Security. Medicare provides coverage for hospitalization, doctors and other types of medical expenses. Medicare is a medical insurance program, and except for a limited short term nursing home benefit, does not cover the costs of nursing home or other long-term care.
What is Medi-Cal? www.medi-cal.ca.gov
Medicaid is a program funded by a combination of federal, state, and local taxes, and can vary from state to state. Medicaid covers low-income people of every age. Usually Medicaid recipients pay no part of costs for covered medical expenses, although sometimes a small co-payment is required. The program is designed to pay for long-term care, including nursing home care. In California, we call our Medicaid program Medi-Cal. (So for California residents, Medicaid and Medi-Cal mean the same thing.) See the Medi-Cal website for more info.
What is MediGap?
Because Medicare requires co-payments and deductibles, Medigap private insurance is available to cover those costs.
What is Social Security?
For many people, especially those who are retired, widowed or disabled, Social Security becomes an important source of income. Social Security benefits are allocated based on one's age and the number of years worked. To receive benefits, a retired individual applies to the Social Security Administration at age 66 or 67 (depending on whether their birth date was before or after 1969), or at age 62 (to begin receiving a reduced level of benefits). Seniors who delay retirement can increase the benefit amount received when they do apply. Disabled individuals should apply as soon as they become disabled; benefits begin after six months. Survivor's benefits should be applied for as soon as possible, as benefits may not be retroactive.
What is In Home Supportive Services (IHSS)? www.dss.cahwnet.gov
In California, the IHSS Program can help some people pay for services provided to them so that they can remain safely at home. To be eligible, you must be over 66 years of age, or disabled or blind. IHSS is considered an alternative to out-of-home care, such as nursing homes, Programs of All-inclusive Care for the Elderly (PACE), or board and care facilities. People in the IHSS program can also attend an Adult Day Service program.
The types of services, which can be authorized through IHSS, are housecleaning, meal preparation, laundry, grocery shopping, personal care services (such as bowel and bladder care, bathing, grooming and paramedical services), accompaniment to medical appointments, and protective supervision for the mentally impaired.
You may be eligible for IHSS if you are eligible for Supplemental Security Income/State Supplementary Payment (SSI/SSP); or you meet all the eligibility criteria for SSI/SSP except that your income is in excess of the SSI/SSP income level; or you are a Medi-Cal recipient who meets SSI/SSP disability criteria.
To apply for IHSS in Alameda County, call (510) 577-1900. To apply for IHSS in Contra Costa County, call (925) 313-1770.
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