Long Term Care (LTC)
LTC services are provided in facilities that provide 24-hour care and, as a minimum, includes nursing, dietary, pharmaceutical services, and an activity program. LTC medical facilities include acute care hospitals/psychiatric hospitals, intermediate care facilities, and skilled nursing facilities.
Medi-Cal can cover individuals residing in LTC facilities. While Medi-Cal for LTC does not pay for all medical expenses, the program can cover the amount that exceeds the monthly Share of Cost (SOC). The SOC is a monthly deductible for individuals that must be paid for medical expenses each month before Medi-Cal begins to cover medical costs. Not all individuals will have the same SOC.
What is the process?
Medi-Cal Application
You can apply for Medi-Cal by:
- Phone, Fax, In Person
- See the Locations, directions and hours of operations for each office below
- Online
AVOID SCAMS: Medi-Cal will NEVER ask for money to enroll or renew coverage. To report scams, call 1-800-822-6222.
Application Received and Verified
Once a Long Term Care Medi-Cal Application is received the information is verified, that information is then compared to the criteria of the many different Medi-Cal programs available.
Eligibility Approved
If eligible, the Approval Notice of Action will have instructions on how to use Medi-Cal. You will also separately receive important documents/cards for your coverage:
- A plastic Benefits Identification Card called a BIC o Keep this card even if your Medi-Cal discontinues o If a new BIC is needed, contact the worker listed on the Notice of Action
- A welcome packet including an eligibility card from CenCal, San Luis Obispo County’s Managed Care company
Notification of Approval/Denial
Results of the approval or denial of your Long Term Care Medi-Cal application will be sent to you in writing.
Who is eligible?
Those who are expected to reside in a LTC facility for 30 or more consecutive days for certain applicants and a full calendar month for single applicants
Is there a charge for this service?
Medi-Cal does not have a premium or charge for the service. However, Medi-Cal for those in an LTC facility may have a Share of Cost (SOC). The SOC is a monthly deductible in a dollar amount that an individual or household would have to pay in medical expenses before Medi-Cal covers the costs.
When and where is this service offered?
Applications for programs can be done by phone, fax, online, and in person at any of the six Department of Social Service Offices or online at www.coveredca.com or BenefitsCal. Offices are open 8-5 Monday – Friday excluding holidays
Location, directions and hours of operation
Click on location name to show hours of operation, directions and phone information
Monday - Friday 8-5
1086 East Grand Avenue
Arroyo Grande, CA 93420
Tel: (805) 474-2000
Monday - Friday 8-5
9630 El Camino Real
Atascadero, CA 93422
Tel: (805) 461-6000
Monday - Friday 8-5
600 Quintana Road
Morro Bay , CA 93442
Tel: (805) 772-6405
Fax: (805) 772-6409
Monday - Friday 8-5
681 West Tefft Street Suite 1
Nipomo, CA 93444
Tel: (805) 931-1800
Monday - Friday 8-5
406 Spring Street
Paso Robles, CA 93446
Tel: (805) 237-3110
Monday - Friday 8-5
3433 South Higuera
San Luis Obispo, CA 93401
Tel: (805) 781-1600
FAQS
Yes, there are different rules within the Long Term Care (LTC) program depending on whether there is a married applicant with a spouse at home, or a single or widowed applicant.
When there is a spouse of a LTC applicant, the program has a higher property limit, and allows income to be allocated back to the spouse at home, up to a certain limit. These limits, both property and income, increase almost every year.
When the applicant does not have a spouse at home then the property limit is the same as other Medi-Cal programs with property/asset tests. The income that the applicant is allowed to retain is much less as their needs are being met at the facility.
