SSI (Supplemental Security Income) and Medi-Cal are both programs designed to support low-income individuals in need, but they serve different purposes and have distinct eligibility requirements. Understanding the differences between SSI and Medi-Cal can help you navigate these programs and determine which one is best suited for your needs. Here’s an overview of each program, how they differ, and what you need to know to qualify.
What is SSI?
SSI, or Supplemental Security Income, is a federal program that provides financial assistance to individuals who are disabled, blind, or over the age of 65 and have limited income and resources. SSI is managed by the Social Security Administration (SSA) and aims to help recipients meet basic needs for food, clothing, and shelter.
Eligibility Criteria for SSI
To qualify for SSI, applicants must meet strict income, asset, and residency requirements:
- Income Limits: SSI has specific income limits that vary based on individual circumstances, including wages, pensions, and other financial support. The SSA excludes certain income, such as food stamps, from these calculations.
- Asset Limits: SSI has an asset limit of $2,000 for individuals and $3,000 for couples. Assets include items like cash, bank accounts, and property, but some assets (like your primary home and one vehicle) are exempt.
- Residency and Citizenship: You must be a U.S. citizen or legal resident to qualify for SSI. Additionally, you must reside within the United States.
If you meet these criteria, SSI can provide monthly cash payments to assist with everyday expenses. Many SSI recipients automatically qualify for Medi-Cal, but the process can vary based on the state.
What is Medi-Cal?
Medi-Cal is California’s Medicaid program, providing health coverage for low-income individuals and families. Unlike SSI, which offers cash assistance, Medi-Cal focuses on healthcare benefits, helping eligible residents access medical services at reduced or no cost.
Eligibility Criteria for Medi-Cal
Medi-Cal eligibility is based on income and household size, with additional considerations for specific groups:
- Income Limits: Medi-Cal’s income limits are based on the Federal Poverty Level (FPL), which varies depending on household size and specific needs. Generally, individuals with income at or below 138% of the FPL may qualify.
- Categorical Eligibility: Medi-Cal covers specific groups, including pregnant women, children, seniors, individuals with disabilities, and some adults without dependents.
- Residency and Citizenship Requirements: To qualify for full-scope Medi-Cal, you must be a U.S. citizen or meet certain residency criteria. Some non-citizens may qualify for limited-scope Medi-Cal covering emergency services.
Medi-Cal provides a wide range of healthcare benefits, from doctor visits and hospital stays to prescription drugs and preventive services.
Key Differences Between SSI and Medi-Cal
While SSI and Medi-Cal are both aimed at assisting low-income individuals, they differ in several important ways:
- Purpose of Benefits
- SSI: Provides monthly cash assistance to cover basic needs.
- Medi-Cal: Offers health insurance coverage for medical and health-related services.
- Eligibility Requirements
- SSI: Has strict income, asset, and disability requirements.
- Medi-Cal: Primarily income-based and includes various eligibility categories (e.g., children, seniors, pregnant women).
- Automatic Qualification
- Many people who qualify for SSI also qualify for Medi-Cal automatically. However, it’s essential to verify your eligibility for each program, as automatic enrollment can vary by case.
Understanding these differences can help you determine which program is right for you or if you qualify for both SSI and Medi-Cal.
How to Apply for SSI and Medi-Cal
Applying for these programs involves different processes, as they are managed by separate agencies.
Applying for SSI
To apply for SSI, you can complete the application online, by phone, or in person at a Social Security office. Here’s what you’ll need:
- Proof of Identity: Such as a birth certificate or Social Security card.
- Income and Asset Information: Including bank statements, property deeds, and other documentation.
- Medical Records (for disability claims): If you’re applying based on a disability, include detailed medical records to support your claim.
Applying for Medi-Cal
Medi-Cal applications can be completed online through California’s Health Insurance Marketplace (Covered California) or at your local county office. Documents you’ll need include:
- Proof of Identity and Residency: Such as a California ID or utility bill.
- Income Verification: Recent pay stubs, tax returns, or other proof of income.
- Household Information: Including Social Security numbers for each household member.
If you’re approved for SSI, the Social Security Administration may automatically enroll you in Medi-Cal, so check with your caseworker to confirm your eligibility.
Seeking Help with Your SSI or Medi-Cal Application
Applying for SSI or Medi-Cal can be complex, especially if you’re facing health challenges or limited financial resources. Seeking assistance from an experienced attorney can help simplify the process and improve your chances of a successful application. An attorney can guide you through each step, ensure your application is complete, and help you gather the necessary documentation.
If you have questions about qualifying for SSI or Medi-Cal or need assistance with your application, contact PLBH at (800) 435-7542 for a consultation. Our team is here to support you and make the process as smooth as possible.