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Medicaid Qualifications

Medicaid is a health insurance program provided by the federal government through which individuals with limited financial resources receive assistance in paying some or all of their medical bills.  Medi-Cal is the California state program, which provides Medicaid eligible individuals with the funds made available under Medicaid program.  It is important to note that the funds available under Medicaid/Medi-Cal are paid directly to the entities and businesses that provide medical services and supplies to Medicaid/Medi-Cal; Medicaid/Medi-Cal recipients do not personally receive any funding from either the federal or California state governments.

To qualify for Medicaid/Medi-Cal, a person must either receive cash assistance through one of the following programs:

  • Social Security Income (SSI)/State Supplemental Program (SSP);
  • California Work Opportunity and Responsibility for Kids (CalWORKs), previously called Aid to Families with Dependent Children (AFDC);
  • Refugee assistance; or
  • Foster care or adoption assistance program

Alternatively, a person may also qualify for Medicaid/Medi-Cal if he or she is:

  • 65 or older;
  • Blind;
  • Disabled;
  • Under 21 years of age;
  • Pregnant;
  • Diagnosed with breast or cervical cancer;
  • Are in a skilled nursing or intermediate care facility;
  • Refugee status during a limited period of eligibility; or
  • Parent or caretaker relative of a child under 21 years of age and
    • The child’s parent is deceased or does not live with the child, or
    • The child’s parent is incapacitated, or
    • The child’s primary wage earning parent is unemployed or underemployed.

Although, Medicaid/Medi-Cal is primarily only available to individuals with minimal assets and resources, it is sometimes possible for an individual, who would otherwise be ineligible for benefits, to receive benefits through the use of estate planning techniques.  Additionally, the application of certain estate planning techniques may also allow individuals receiving Medicaid/Medi-Cal benefits to avoid their estate being diminished by Medicaid/Medi-Cal reimbursement claims.

If you or your loved one are interested in learning how to qualify or maintain your Medicaid/Medi-Cal benefits, please contact our office.

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