Insurance & Social Security

Health Insurance


The following is general information on Medi-Cal and HealthPAC.  Should you require further information, please follow the links provided.  You may also contact the Mental Health Association of Alameda County for additional information and assistance with obtaining health coverage.  


Medi-Cal
Do you qualify for Medi-Cal benefits?

If you are enrolled in one of the following programs, you can get Medi-Cal:


•SSI/SSP
•CalWorks (AFDC)
•Refugee Assistance
•Foster Care or Adoption Assistance Program
 

You can also get Medi-Cal if you are:


•65 or older
•Blind
•Disabled
•Under 21
•Pregnant
•In a skilled nursing or intermediate care home
•On refugee status for a limited time, depending how long you have been in the United States
•A parent or caretaker relative or a child under 21 if:


The child's parent is deceased or doesn't live with the child, or
The child's parent is incapacitated, or
The child's parent is under employed or unemployed•Have been screened for breast and/or cervical cancer (Breast and Cervical Cancer Treatment Program)
 

Contact your local County office for more information or apply on-line at www.benefitscal.org


Medi-Cal -  How to Apply


•Call or visit your local County Social Services office and ask for a Medi-Cal application or Apply on-line (Not DHCS)

•If you need help filling out the forms, call the county social services agency, or contact the Mental Health Association of Alameda County.

•Mail or take your application with the required verifications (proof) to the nearest social services agency in your county. If you don’t have all your verifications, or are not sure of what you need, please send what you have. You can send the rest later. The sooner the social services agency receives your application, the sooner your case may be processed and your Medi-Cal benefits can begin.

•If you get SSI/SSP payments, your Social Security administration office automatically sets up Medi-Cal for you. No separate application for Medi-Cal is needed. You will get your Medi-Cal card (BIC) in the mail.

•If you get CalWORKs payments, the county social services agency automatically sets up Medi-Cal for you. No separate Medi-Cal application is needed. You will get your Medi-Cal card (BIC) in the mail.The California Department of Mental Health administers a number of programs for children and youth. The programs’ services are directly provided at the local level by counties and their contract providers. To find local mental health services, contact your local county mental health agency


The Network of Care for Mental Health is a great resource to obtain information about mental health issues and to search for a wide variety of mental health and other support services in your local community.  To find local mental health services, contact your local county mental health agency.


For more information about California Department of Mental Health programs for children and youth, contact the DMH Children and Family Program Policy office at (916) 654-2680.


HealthPAC


What is HealthPAC?HealthPAC (formerly known as CMSP or ACE) provides comprehensive health care services through a contracted network of health care providers.Health services are provided through the HealthPAC Provider Network, which includes both the Alameda County Medical Center and primary care community-based organizations.Who does it cover?In order to be eligible for HealthPAC coverage individuals must:


1.    Be a resident of the County of Alameda
2.    Have a gross monthly income at or below the 200% Federal Poverty Level
3.    Not be enrolled in or eligible for full- scope Medi-Cal


How do I apply?


If you think that you may be eligible for this program, contact one of the following providers.When you call one of the providers you should expect to go through an eligibility screening process.


If you have questions about the program or eligibility requirements, please call HealthPAC Customer Services at 1-877-879-9633 or email at HealthPACquestions@acgov.org.  (This is not a secure e-mail. Do not put personal health information in the e-mail.)


Where can I get more information?


Call HealthPAC Customer Service at 1-877-879-9633, Monday – Friday, 8:00 A.M. – 5:00 P.M., or visit them online here.

Social Security

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security disability insurance program (title II of the Social Security Act (the Act)) and the supplemental security income (SSI) program (title XVI of the Act).


Title II provides for payment of disability benefits to individuals who are "insured" under the Act by virtue of their contributions to the Social Security trust fund through the Social Security tax on their earnings, as well as to certain disabled dependents of insured individuals. Title XVI provides for SSI payments to individuals (including children under age 18) who are disabled and have limited income and resources.


The Act and SSA's implementing regulations prescribe rules for deciding if an individual is "disabled." SSA's criteria for deciding if someone is disabled are not necessarily the same as the criteria applied in other Government and private disability programs.  


Definition of Disability


For all individuals applying for disability benefits under title II, and for adults applying under title XVI, the definition of disability is the same. The law defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.


Who can get disability benefits under Social Security?


Under the Social Security disability insurance program (title II of the Act), there are three basic categories of individuals who can qualify for benefits on the basis of disability:


•A disabled insured worker under full retirement age.
 

•An individual disabled since childhood (before age 22) who is a dependent of a parent entitled to title II disability or retirement benefits or was a dependent of a deceased insured parent.
 

•disabled widow or widower, age 50-60 if the deceased spouse was insured under Social Security.


Under title XVI, or SSI, there are two basic categories under which a financially needy person can get payments based on disability:


•An adult age 18 or over who is disabled.
 

•child (under age 18) who is disabled.


What is a "Medically Determinable Impairment"?


A medically determinable physical or mental impairment is an impairment that results from anatomical, physiological, or psychological abnormalities which can be shown by medically acceptable clinical and laboratory diagnostic techniques. A physical or mental impairment must be established by medical evidence consisting of signs, symptoms, and laboratory findings-not only by the individual's statement of symptoms.


The Disability Determination Process


Most disability claims are initially processed through a network of local Social Security field offices and State agencies (usually called disability determination services, or DDSs). Subsequent appeals of unfavorable determinations may be decided in the DDSs or by administrative law judges in SSA's Office of Disability Adjudication and Review.


How is the disability determination mad


SSA’s regulations provide for disability evaluation under a procedure known as the "sequential evaluation process." For adults, this process requires sequential review of the claimant's current work activity, the severity of his or her impairment(s), a determination of whether his or her impairment(s) meets or medically equals a listing (see Part III of this guide), the claimant's residual functional capacity, his or her past work, and his or her age, education, and work experience. 


For children applying for SSI, the process requires sequential review of the child's current work activity (if any), the severity of his or her impairment(s), and an assessment of whether his or her impairment(s) results in marked and severe functional limitations. If an adult or child is found disabled or not disabled at any point in the evaluation, the evaluation does not continue.


For further information, please contact the California Social Security Website here.


SSI Payee Assistance


Should you require help finding a payee for your loved one.  Below are a few options:

Alameda County Substitute Payee Program Edit this page  History Alameda County Substitute Payee Program:


Money management for people with psychiatric diagnoses only. Must be on SSI or SSA. Clients cannot have a private savings or checking account and can only be referred through Alameda County mental health clinics or hospitals. Clients must have a county contact person (case manager) following their case. Will accept calls from therapists or social workers for packets to be mailed out. Spanish. Wheelchair accessible. 


Address  P.O. Box 129,
San Leandro, CA  94577 

Phone:  510-383-1582
Fax:    510-383-1583   
 
Hours  M-F: 8am-5pm  




Alameda County Public Guardian-Conservator


The Public Guardian-Conservator manages Probate and mental health (Lanterman-Petris-Short, known as LPS) conservatorships for Alameda County residents who have been adjudicated by Superior Court either to lack capacity to manage finances and/or health care or to be gravely disabled to mental illness or substance abuse. The Public Guardian-Conservator works in partnership with Adult Protective Services (APS) to protect elders and dependent adults who are victims of financial abuse or exploitation and who are unable to protect themselves. For more information, call (510) 577-3585.