You may still get Medi-Cal under the DD Waiver. The main purpose of the DD Waiver is to help keep you out of an institution and in the community. So, even if your family income is too high, you may be eligible for Medi‑Cal because they will not count your parents’ or spouse’s income or resources.
Medi-Cal is allowed to determine your eligibility using “institutional deeming.” This means Medi‑Cal will evaluate you for eligibility as if you lived in an institution, and not with your parents or spouse. This means you are not in your parents’ or spouse’s MFBU (See Question 11). This is because Medi-Cal only counts your own income and resources (which are often low or none), when you live in an institution.
Medi-Cal is allowed to use institutional deeming to determine your Medi-Cal eligibility, because people on the DD Waiver are already qualified to get services in an ICF/DD (intermediate care facility).
This is how the process works:
- The regional center determines that you qualify for DD Waiver services, but you are not eligible for Medi-Cal because of your parents’ or spouse’s income or resources.
- The regional center contacts the county waiver contact person asking if you are eligible for Medi-Cal without counting your parents’ or spouse’s income.The procedures are explained in Department of Health Care Services All County Welfare Directors Letters (ACWDLs) Nos. 00-08, 00-59, 01-24.
- The county waiver contact person uses institutional deeming to look at your application, and will decide if you are eligible for no-cost or share-of-cost Medi‑Cal. See Question 13 and 14 for when you might have Medi-Cal with a share of cost.
- If you are eligible, you will qualify for Medi‑Cal under a special code.
- Your Medi-Cal will be “full-scope,” which means you can see doctors, go to the hospital, and have other Medi-Cal services. The regional center can pay for some of your regional center services using Medi-Cal.
|↑1||The procedures are explained in Department of Health Care Services All County Welfare Directors Letters (ACWDLs) Nos. 00-08, 00-59, 01-24.|