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Adult Medicaid

This program is designed to help with the medical costs for individuals who are aged, blind or disabled. Services covered include: payment of Medicare premiums, inpatient hospital care, doctors visits and clinical services, outpatient hospital visits, licensed home care services, eyeglasses, prescription medicine, laboratory and x-ray services, nursing and hospice care, durable medical equipment, (e.g. walker), medically necessary ambulance transport, dental care.  Individuals who are eligible for full Medicaid benefits receive a Medicaid card each month. Medicaid may also be retroactive to cover medical bills from the 3 months prior to the month of application.

Eligibility Information:

Eligible applicants must:

  • Be age 65 or older, or under 65 and unable to work due to a severe disability that is expected to last at least 12 months.
  • Have monthly income within allowable limits. Income includes: Social Security, Veterans Benefits, pensions and other retirement benefits, wages (some income can be disregarded).  If monthly income exceeds the set amount, the person must meet a deductible based upon the Medically Needy income limits.  (Current income limits can be found here.)
  • Have resources that are no more than $2,000 for an individual, or $3,000 for a couple. Resources include: cash, bank accounts, second car, retirement accounts, stocks and bonds, and real estate that is not your home. Resources do not include your home, one car, household furnishings, clothing or other personal effects such as jewelry.

This is just a guide.  An eligibility worker at the Department of Social Services will assess your individual situation and inform you of your eligibility status.

Application Information:

Individuals can fill out an application at either building of the Orange County Department of Social Services.  Applications generally need to be made in person by the applicant or his representative.  Persons receiving SSI (Supplementary Security Income) are automatically eligible, and can apply at the Social Security Administration Office.

Aplications can also be downloaded here.

Bringing the following items will aid in the process of applications:

  • Identification
  • Social security cards or numbers for all persons you are applying for
  • Copies of all medical or life insurance policies for all persons you are applying for
  • Most recent bank statements
  • Current statements for any source of income including as Social Security, retirement benefits, Veterans benefits or child support
  • Proof of alien status for applicants who are not US citizens

Programs

There are several programs offered under Adult Medicaid. Listed below are the most common Medicaid programs for adults.

  • Medicaid for Older Citizens (MAA) - Medical coverage for people 65 or older whose income is below the specified limits.
  • Medicaid for the Blind or Visually Impaired (MAB) - Medical coverage for blind or visually impaired people of any age who are blind according to the definition given by the Social Security Administration and meet the specified income requirements.
  • Medicaid for Disabled Citizens (MAD) - Medical coverage for people of any age who are unable to work due to a disability that is expected to last at least 12 months and meet the specified income requirements.
  • Special Assistance to the Disabled (SAD) - Medical coverage for clients in rest homes or adult care homes who meet specified income requirements.
  • Medicaid for Community Alternatives Program (M-CAP) - Pays costs of in-home nursing care for those persons wishing to remain in the home instead of going to a nursing facility.
  • Long Term Care Medicaid (LTC) - Helps pay cost for care in a facility that primarily provides inpatient medical care.
  • Medicare Qualified Beneficiary (MQB) - Partial coverage for people receiving Medicare, also known as Medicare-Aid

Frequently Asked Questions