Detailed Medi-Cal Program Information
AGED, BLIND AND DISABLED
250 Percent Working Disabled Program allows persons that meet the federal definition of disability but are still working to buy into the Medi-Cal program by paying monthly premiums on a sliding scale based on their income.
Long-Term Care (LTC) provides care for the aged and persons with disabilities who may reside in a skilled nursing or intermediate care facility. Long-term care is associated with several individual Medi-Cal programs.
Medicare Premium Payment Programs
- Qualified Medicare Beneficiary (QMB) pays for the Medicare Part A and B premiums, co-insurance and deductibles. Qualified families must have income at or below 100% of the Federal Poverty Level. Click here for more details
- Specified Low-Income Medicare Beneficiary (SLMB) pays for Medicare Part B premiums if the family income is at or below 120% of the Federal Poverty Level. Click here for more details
- Qualifying Individual 1 (QI-1) pays for Medicare Part B premiums for families whose income is between 120% and 135% of the Federal Poverty Level. Click here for more details
- Qualified Disabled Working Individual (QDWI) pays the Medicare Part A premium for people who have lost entitlement to free Part A benefits due to substantial employment. Family income must be at or below 200% of the Federal Poverty Level and the family must be eligible to Medi-Cal under another program. Click here for more details
State Programs – Disability Evaluation Division (SP-DAPD)
- Individuals who are between the ages of 21 and 64 who allege disability and have not applied for disability with the Social Security Administration will have their disability determined by SP-DAPD. This determination is made using criteria from the Aged, Blind, and Disabled-Medically Needy (ABD-MN) Title XIX program.
- Individuals must have severe physical and/or mental disorders lasting at least 12 months that prevent the individual from working during the same 12 months, or have a disability that will result in death. The disability must be proven by the use of medical records, tests, or other medical findings.