Frequently Asked Questions
What is the difference between Medicare and Medi-Cal?
- Medicare is the Federal Government’s Medical Insurance Program for people age 65 and older (and for people who are disabled.)
- Medi-Cal is the state-run medical assistance program for people in financial need.
Will Medicare pay for all or part of my stay at Arroyo Grande Care Center?
- Your Medicare benefits are “activated” by a 3-night stay in a hospital within the last 30 days.
- Your physician must certify that you need skilled nursing care. (For example: skilled nursing may be determined by a need for Physical Therapy after your 3-night qualifying stay in a hospital due to weakness/strengthening after a surgery.)
Once these guidelines have been met, Medicare will pay for days 1-20 at 100% if you require skilled nursing care throughout that period. After day 20, if you still require skilled care, there is a co-insurance daily rate charge that many secondary insurances (AARP, Blue Cross) will cover. To find out if your secondary insurance pays for this co-insurance rate, call the number listed on the back of your secondary insurance card for more information.
How do I qualify for Medi-Cal?
- Your income must be less than state limits.
- Your assets must be less than state limits.
- A physician must certify that you need nursing home care.
For more information, please visit the Department of Social Services and to obtain an application for Medi-Cal eligibility.
For further information about Medicare, Medi-Cal and other insurances, call Arroyo Grande Care Center at (805) 489-8137 directly or HICAP (Health Insurance Counseling & Assistance to Senior Citizens) at 1-800-434-0222.