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Medi‑Cal Assisted Living Waiver (ALW) in San Mateo

✅ Medi‑Cal Assisted Living Waiver (ALW) in San Mateo
🏠 What it covers:

  • Pays for personal care, housekeeping, meals, medication help, transportation, skilled nursing visits, and social support in an approved RCFE Paying for Senior  

  • Does NOT cover room & board—that must be paid separately, usually from SSI or personal income .

✅ Eligibility criteria:

  • Age 21+ (or 65+) with full‑scope Medi‑Cal and zero share-of-cost.

  • Nursing-facility level of care required.

  • Must reside in a participating county—San Mateo is included  

  • Able to pay room & board and have funds left for personal needs  

💰 Reimbursement to RCFE:

  • California pays ALW caregiving via daily tiered rates (Tier 1–5) per diem:

    • Tier 1: $93 / day → **$2,800/month**

    • Tier 2: $112 / day → **$3,360/month**

    • Tier 3: $130 / day → **$3,900/month**

    • Tier 4: $176 / day → **$5,280/month**

    • Tier 5: $265 / day → **$7,950/month** 

💸 Room & board typical cost:

  • Usually $1,200–1,500+/mo, depending on facility. SSI recipients often use benefits to cover this Paying for Senior 

🧭 Quick Summary – San Mateo

Coverage                                                                          Medi‑Cal ALW                                                         Medicare

Care services (personal care, nursing visits, coord.)✅ Covered via tiered daily rates                       ❌ Not covered

Room & board                                                                ❌ Must be paid privately (e.g. SSI, income)   ❌ Not covered

Eligible in San Mateo?                                                   ✅ Yes – county is includedN/A

📌 Next Steps if You’re Interested:

  1. Confirm Medi‑Cal eligibility (full‑scope, no share-of-cost).

  2. Contact a Care Coordination Agency (CCA) in San Mateo county to apply and get assessed.

  3. Join the ALW waitlist—note: wait times can range from 6 months to 2 years unless expedited from a nursing home or with APS intervention RedditSenior Homes+1Wikipedia+1Paying for Senior CareWikipedia+12Universal Home Care+12Purple Door Finders+12Reddit+5Reddit+5Purple Door Finders+5.

  4. Identify ALW-participating RCFEs in San Mateo and check what their room & board rates are.

 

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