Amma, Appa, Move To California: We Have Free Health Insurance For You

SAN FRANCISCO, California — One of the primary concerns for Indian American immigrants is the health of their aging parents. Many would hope to resettle their parents in the U.S. but are daunted by the possibility of large medical bills.

Immigrant seniors who are legal permanent residents can buy into an Affordable Care Act plan — also known as Obamacare — but often pay high monthly premiums or high co-pays and deductibles.

For low-income residents of California, healthcare costs became less of a concern this year, when on Jan. 1, the state rolled out its final phase of Medi-Cal expansion, providing free healthcare to all residents, regardless of immigration status. California is the first state in the nation to provide health care coverage to undocumented residents. No proof of immigration status is required to enroll.

Medi-Cal expansion benefits Indian American seniors

The expansion provides a huge boon to Indian American seniors living in California. According to Pew Research Center data, an estimated 300,000 Indians over 65 reside in the U.S. 13% live in California. About 8% of Indian American seniors nationwide live below the federal poverty line, currently about $15,000 per year.

About 50,000 Indian American seniors nationwide are undocumented, according to 2010 Census data. Most become undocumented by overstaying a tourist visa.

Seniors can provide proof of California residency via a utility bill or a rental agreement; there is no requirement as to how long they have lived in California.

Seniors must also be able to provide proof of income and prove that they intend to stay in California indefinitely. Additional eligibility requirements for the Medi-Cal Older Adult Expansion Program can be found here .

Access to affordable, quality healthcare

Medi-Cal expansion for seniors has been in effect since May 1, 2022. This January brought about the final phase of expansion, which now includes all low-income residents of the state.

“In California, we believe everyone deserves access to quality, affordable health care coverage – regardless of income or immigration status,” California Governor Gavin Newsom said when signing the bill in 2021. “Through this expansion, we’re making sure families and communities across California are healthier, stronger, and able to get the care they need when they need it.”

Indian American seniors with less than $20,783 for a single person or $28,208 for a couple can avail of Medi-Cal benefits under the expansion. Beginning Jan. 1, Medi-Cal eligibility is based solely on income. Assets are not included, meaning a person can own a home, car, or stock portfolio and still be eligible for benefits, explained Yingjia Huang, Assistant Deputy Director at the California Department of Health Care Services. “Those are considered assets that no longer need to be verified, or included in the basis of the determination,” she told India Currents in an interview.

Medi-Cal for retirees

People living on retirement or pension benefits of under $1,732 per month would qualify for Medi-Cal, Huang clarified.

Eliminating assets from Medi-Cal eligibility determination was implemented in three phases. The final phase was rolled out in January.

Adriene Clark, Client advocate at the Alameda County Department of Social Services, told India Currents that retired seniors who choose to live with their family are still eligible for expanded Medi-Cal, as eligibility is determined solely on their income, not the income of the household in which they live. They can have a house, car, and other assets in the home country, she said, noting such assets will not be included in eligibility determination.

Stock portfolios can also be kept, but dividends and payouts from stock would be counted as income.

“More people will be able to see health care providers when they need to, which will reduce sickness and guarantee more wellness throughout the state,” said Clark.

Scope of services

Full-scope Medi-Cal includes a variety of services, including routine and emergency health visits, medication, and medical supplies, including hearing aids, personal attendant care, referrals to specialists, and even transportation to and from doctors and pharmacy visits.

More recently, the California Department of Health Care Services, which oversees Medi-Cal, has attempted to avoid the stigma surrounding mental health care by pairing it with programs such as free acupressure and Qigong classes . One out of 5 Asian Americans need mental health services, but fewer than 1 in 50 seek it out. The reluctance to seek mental health care is especially acute among older Asian adults.

Medi-Cal will not pay for room and board at an assisted living facility, but will pay for services rendered at the facility, explained Joseph Billingsley, Assistant Deputy Director, Integrated Systems of Care, Health Care Delivery Systems at DHCS. Those who need assisted living facilities would have to find a means to pay for their room and board. Assisted living waivers are available through the state to help with room and board costs, but are currently only available in 15 counties, Billingsley told India Currents.

Folks who qualify for an assisted living waiver must use one of the assisted living facilities that have been approved by the state. Those approved facilities are called Residential Care Facilities for the Elderly and are equipped to take Medi-Cal. Residents, however, may still find that they have to pay for some of their room and board, even with a waiver.

Medi-Cal does offer some services for older people who choose to age in their homes.

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