Reference no: EM131098115

CALIFORNIA MEDICAID

See attached sample template for a response to the below post. The sample is a totally different subject, it's just provided as a sample for the type of feedback needed fot the below homework assighnment.

Home State: CALIFORNIA

Minimum Wage in California: $10.00 per hour² (my friend is a waitress)

Part-time basis:  34 hours per week⁴  - part time is 1-34 hours per week.  ($16,320 annual household salary)

Eligibility requirements for Medicaid/MediCal:

Since my friend's spouse is currently in a rehab hospital.  My friend can apply for Hospital Presumptive Eligibility (HPE) Program.  This program will provide "immediate access to temporary, no-cost Medi-Cal while applying for permanent Medi-Cal coverage."¹ The qualifications include:

• Have income below the monthly limit for household size.¹
• Be a California resident.¹
• Not already haveMedi-Cal.¹
• If not pregnant, have not received PE Enrollment benefits from anyMedi-Cal PE Program up to the maximum limitation allowed within the past 12 months of applying. If pregnant, have not had a PE Enrollment during the current pregnancy of applying.¹

And, be eligible in one of the following HPE groups below:

• Children under 19 years old¹
• Parents and Caretaker Relatives¹(my friend will be the primary caretaker of her husband)
• Pregnant Women (benefits are limited to ambulatory prenatal services.)¹
• Former Foster Youth between ages 18 to 26 years old, who were in foster care in any state on their 18th birthday or older. (No income limit)¹
• Adults between ages 19-64(my friend is only 62 years old),not pregnant, not in Medicare, and not eligible for any group stated above.¹

This is a Medi-Cal benefit for up to 2 months.

They can also qualify based on income since their annual yearly earnings is less than $22,108 for a family size of 2. 

To see if you qualify based on income, look at the chart below. Income numbers are based on your annual - or yearly - earnings.⁵ 

Family Size	138% Poverty Level
1	16,395
2	22,108
2 Adults	22,108

Medi-Cal qualifications may also include the following⁵:

• 65 or older
• Blind
• Disabled
• Under 21
• Pregnant
• In a skilled nursing or intermediate care home
• On refugee status for a limited time, depending how long you have been in the United States
• A parent or caretaker relative or 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
• Have been screened for breast and/or cervical cancer

The Medi-Cal program governs eligibility for benefits on a "means" tested basis. "The 2002 community spouse resource allowances are $89,280 in assets and $2,232 in monthly income.  For a married couple with one spouse in a nursing home and the other spouse at home, the spouse at home may keep up to $89,280 in resources (property and other assets) while the spouse in a nursing home may keep $2,000.  The spouse at home may keep all of the income received in his or her name, regardless of the amount.  If the amount is below $2,232 per month, the spouse in the nursing home may allocate income to bring the at-home spouse's income up to the $2,232 per month limit.  The spouse in the nursing home is permitted to keep $35 a month for personal needs."⁸  

Home care services - yes, they are eligible for In-Home Operations⁶

Adult day health program - yes, they are eligible for Community-Based Adult Services (CBAS) - formerly Adult Day Health Care (ADHC)⁷

Nursing home care - yes, they are eligible care in a skilled nursing facility⁶

The sites are not user friendly.  There is quite a number of FAQs that are not really related to my inquiries.  The search box is not helpful as I one would think.  It took me several attempts to look for the information that I needed to get.  If I had an age- related limitation such as poor vision and hypertension, then I would definitely get a headache and my blood pressure would increase out of frustration.  I did take a long nap during the course of this assignment because it was a bit frustrating not to find the information that I wanted to get immediately and I was getting tired.  Patience is definitely necessary to go over these CA.gov sites.