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Contact Information for Site:

Elder Law Center, P.C.

Attn: Advertising Department 

3600 Lime Street, Bldg. 4-412

Riverside, California  92501

Phone:  1-951-684-5608

Fax:  1-951-684-1106

Email:elc@elderlawcenter.net


​​​​WHAT DOES MEDI-CAL NOT COVER? 

​​​​WHAT DOES MEDI-CAL COVER? 

​​CONTACT US DIRECTLY

To schedule aFREE INITIAL 

CONSULTATION, contact us

Toll Free at 1-800-660-5608, or your can simply CONTACT US online by completing the form below.


The * indicates required information.


M E D I -C A L   C O V E R A G E

Active Membership

 ​​​​​​​​​​In a nursing home setting, the Medi-Cal Program covers room and board.


Other services include:  some prescriptions (although the Medicare Part D program now covers most prescriptions), physician visits, adult day health service, some dental care, ambulance services, some home

health, X-ray and laboratory costs, orthopedic devices, eyeglasses, hearing aids

and some medical equipment, etc.


All covered services, or the remaining costs over the share of cost of nursing home care, will be covered if the individual meets income/resource requirements.   Some services such as home health care, durable medical equipment,  and some drugs require prior authorization. 

 

Also, it covers virtually all of the gaps in a Medicare Supplemental Insurance Plan.


The Medi-Cal Program also pays the Medicare Part A and Part B deductibles and co-pays for many recipients, and has no maximum stays for most medically necessary services,

including long-term nursing home care.


 Nursing home careis covered if there is prior authorization from the physician/health care provider.


Residents are admittedon a doctor's order and their stay must be "medically necessary". 


Residents are allowedto keep $35 of their income as a personal needs allowance.


Residents with no income may apply for the Supplemental Security Income/State Supplemental Program (SSI/SSP), and,if eligible, they will receive a payment of $50 as a personal needs allowance.

 

If the individual qualifies for Medi-Cal, he/she does not need private "medigap"  or HMO insurance to pay for costs, though if such insurance is carried, the premiums are deducted from income when computing the share of cost, and therefore costs the beneficiary nothing. 


If the HMO coverage includes drug benefits, maintaining the HMO coverage may become more important, as the beneficiary will continue to receive drug benefits from the HMO, which may be more comprehensive than the Medicare Part D coverage.

 


Elder Law Center, P.C, 

3600 Lime Street

Building 4, Suite 412 
Riverside, CA 92501

Main Phone

1-951-300-2122

Other

1-951-684-5608

Toll Free

1-800-660-5608

Fax

1-951-684-1106

E-mail Address

info@elderlawcenter.net

www.elderlawcenter.net


​​​​​CONTACT US TODAY

FREE Initial Consultation

Toll Free  

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Phone 

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 For More Information

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​​​​​​​The Medi-Cal Program  does not cover  certain personal expenses like haircuts, beauty shop charges, cell phones, and clothing.

However, once an individual is qualified  for Medi-Cal benefits, he or she is allowed to retain a portion of his or her monthly income to meet the aforementioned expenditures. 

This allocation is defined as the individual’s “monthly personal needs benefit.” 


In California, this monthly personal needs benefit amount is $35.00.

The Medi-Cal Program  also does not cover  the following essentials: 
       

​         *   Specially prepared food, beyond that generally prepared by the facility;

          *   Telephone, television, radio;

          *   Personal comfort items including tobacco products and confections;

          *   Cosmetic and grooming items and services in excess of those included in the basic  service;

          *   Personal clothing or personal reading materials;  

          *   Gifts purchased on behalf of a resident, flowers or plants;  

          *   Social events and activities beyond the activity program, or 

          *   Special care services not included in the facility's Medi-Cal payment.

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