Healthcare Costs and the Medi-Cal Program In California

healthcare costsHas anyone else noticed the rise in healthcare expenses? Not only are the costs of medical care and prescriptions going up, but premiums are on the rise as well. More employers are shifting a higher portion of the costs of healthcare to the employees, including higher deductibles and co-pays in many instances.

And this issue is only enhanced by the decrease in monies provided for state and federal run healthcare plans, such as Medi-Cal in California or Medicaid programs. Those who may have previously benefited from these plans due to being in a lower income bracket are finding themselves having to fork out money for traditional healthcare plans. For those who are in these lower income brackets who barely fall outside of the required income guidelines, it is becoming increasingly difficult to live on remaining dollars after paying for healthcare alone.

For the purposes of the Medi-Cal program specifically, there are several requirements to qualify for the program. The qualifications are really based upon the qualifications for other programs that are state and federally run. If an individual qualifies for cash aid or food stamps, for example, they will likely qualify for Medi-Cal. However, if someone owns a certain amount of property, such as multiple cars or home that is over the allowable limit for the family size then the family would not qualify for health coverage assistance. The general guideline is for property limits starts at $2,000 for the first person and increases with each family member. In addition, the family’s income plays a large factor in determining eligibility for the Medi-Cal program. As an example, a family of four can make a maximum of $4,167/month to receive health insurance benefits. Add an additional $708 for each additional family member to find the maximum amount of allowable income for larger families. Other factors include things such as: if a family member has a serious illness or disability, if the woman is pregnant, if there are children in the family, or if a family member needs specific health care, such as nursing home care, cancer treatment, or dialysis, to name a few.

Please don’t get me wrong. I believe that abuse of the Welfare program (i.e. cash aid, food stamps, medical assistance, homeless assistance, etc.) is absolutely wrong. If someone is receiving assistance and not working because they choose not to work (not because they physically can’t work), or if they are receiving assistance but are using the money to purchase drugs or are involved in other illegal activity, then I absolutely believe they should not be able to receive assistance. However, if they are a single-parent household, has a medical emergency, or just can’t make ends meet while working a full-time job, then they should have the opportunity to receive assistance. That is what it is truly meant for.

So, if you don’t qualify for Medi-Cal benefits because you are above their income limits, or you don’t have children, or you don’t have a specific illness or disability, then you’ll likely find yourself paying for healthcare either through your employer or through a stand-alone private health insurance plan. I have had all types of health insurance plans over the years, and I have seen the rise in healthcare costs over the years.

**Please note that this information is current at the date and time of this posting. Please review the specific state requirements for state healthcare as they may have changed.

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