Seniors and Persons With Disabilities

Who is eligible?

You may be eligible to receive Medi-Cal benefits if you are one of the following:

• Aged – Persons age 65 and over
• Blind – Persons who have been declared legally blind by the Social Security Administration or the State Programs - Disability and Adult Programs Division (SP-DAPD).
• Disabled – Persons who have been declared disabled by the Social Security Administration or the State Programs - Disability and Adult Programs Division (SP-DAPD).

If you are a Senior &/or a person with a disability, you may qualify for free or low-cost health care coverage under the Medi-Cal Program. 

Examples of services that might be covered are comprehensive preventative care services, primary and/or specialty care, medical office visits, vision and dental care, mental health services, hospitalization and prescription medicines.

Disability Determinations

For the purposes of receiving Medi-Cal benefits, there are two types of disability:

• Federal disability under Social Security
• State disability under Medi-Cal    

If you have been determined to be disabled by Social Security, you are also considered disabled under Medi-Cal regulations.

If you have not been determined to be disabled by Social Security, you may still apply to receive Medi-Cal benefits as a disabled individual.  In doing so you will need to complete disability paperwork that will then be submitted to the State Programs – Disability and Adult Programs Division (SP-DAPD).  The SP-DAPD determines disability for Medi-Cal using Social Security’s criteria for disability.  The SP-DAPD conducts a disability evaluation and sends the result to the county.

In the event that the SP-DAPD determines that you are not disabled, you have a right to appeal their decision.

Special Medi-Cal Programs For Seniors & Persons With Disabilities

It is possible for a person to be working and considered disabled at the same time provided their income does not exceed the Substantial Gainful Activity (SGA) amount that is based on the federal average wage index.

This is one of many special programs designed to assist Seniors & persons with disabilities with their health care needs. To see if you qualify for the Working Disabled Program or other special programs you should contact your local Social Services Agency Regional Center and initiate an application