What is Medi-Cal?
Medi-Cal is a combined federal and California state program designed to help public assistance recipients and other low income persons pay the costs of medical and dental care, but very importantly in the elder law world and for seniors who need help with activities of daily living, Medi-Cal might more appropriately be described as a non-medical benefit that helps pay for long term care services. For example, Medi-Cal In-Home Care Support Services, or IHSS as it's known, helps pay for services that allow seniors to safely remain living in their home. Medi-Cal also commonly helps seniors pay for ultra-expensive skilled nursing facility care. Beyond IHSS provided in one's home or Medi-Cal funding skilled nursing facility services, there are also Medi-Cal Waiver Programs which help seniors pay for care that falls in between these two extremes.
Since Medi-Cal is a needs-based program, those who seek its assistance must pass certain eligibility requirements. In essence, to qualify for Medi-Cal, a recipient must demonstrate that they have limited resources available. This is in stark contrast to Medicare, which is an entitlement that helps seniors and the disabled pay for medical care. We know this can be confusing. Medicare and Medi-Cal sound so similar and sometimes the benefits stemming from each, even overlap, which makes this area of law truly complex. To summarize though, Medicare (in the elder law world) might more easily be thought of medical insurance that helps provide for medical treatment, while Medi-Cal (which also has many medically related components) is better thought about as a safety net available to help seniors pay for help with activities of daily living, or long term care, either at home or in a more formal setting.
At Kaiden Elder Law Group, we assist seniors and those who love them throughout Valencia and we are able to provide services in both English and Russian. Request a consultation with our team by contacting us online or calling (661) 247-8433 today!
Qualifying for Medi-Cal
When it comes to Medi-Cal Qualification, saying there is a lot of misinformation out there, is perhaps the understatement of the century for elder law attorneys. For example, it is alarming how many California websites assert there is a 5 year look back period on asset transfers. This tidbit is quoted so often on the internet that many of our clients are skeptical when we're forced to try and convince them that that is not the law. Maybe it will one day be the law in California, but for now it's not very helpful to scare Californians into thinking they can't qualify for Medi-Cal for five years (please note that when we wrote this page in 2021, this was the law).
What's worse perhaps is that when we are talking to people who are in need of Medi-Cal, they sometimes try to convince us, that they don't qualify for Medi-Cal, because they have more than $2,000 in assets which they insist disqualifies them from benefits. Now, while it's certainly true that people who have less than $2,000 in assets qualify for Medi-Cal from an asset perspective, it's also true that many who have a net worth in excess of $2,000, also, automatically qualify for Medi-Cal. For example: If your assets include a home that's worth $700,000, and a car that's worth $50,000, and you also have a $250,000 IRA that is paying you minimum required distributions, by definition, you are both a millionaire and at the same time you qualify for Medi-Cal. That's because the Medi-Cal rules classify certain assets as exempt, and they therefore are not counted against you, because exempt assets do not cause Medi-Cal disqualification. That's really good news for people in need of Medi-Cal.
This one insight alone then generally raises the question of what's considered a “free-bee” by Medi-Cal?
Well, as just alluded to, a principal residence, one car, and retirement accounts can all be exempt assets. That's why, in the example just given, some people automatically qualify for Medi-Cal, while having a substantial net worth. Beyond owning a home, car and retirement accounts, people also often have household items and other personal property, burial plots, term life insurance or even whole life insurance and under the right circumstances they still qualify for Medi-Cal. But wait, there's more (as they used to say in infomercials). Yes indeed, it's true, even more assets might be classified as exempt, but the rules are tricky, so people applying for Medi-Cal need to be careful. The main take away however is that there are some pretty big exceptions to the $2,000 cash reserve limit in California. And this arbitrary “limit” really only applies to single individuals. Which is to say if you're married, a well spouse (that is, the spouse who doesn't need Medi-Cal) can have even more, since they're allowed to have over another $130,000 of assets in whatever! So you might be thinking, let me get this straight: I can have a home, car, retirement accounts as well as $130,000 in the bank, AND my spouse can nevertheless qualify for Medi-Cal? The answer is... Yep. With rules as lenient as this, you might be wondering why you even need the help of an elder law attorney. The answer is that, as with many things in life, the devil's in the details and when it comes to Medi-Cal the details are almost endless.
The Importance of Proactive Medi-Cal Planning
Planning ahead is important, especially if you or a loved one needs long-term care at some point in the future. Without appropriate planning, you and your family could find yourselves in the unbelievable position of being forced into becoming impoverished.
Through proactive estate and elder law planning, you can help ensure that you or your loved one will qualify for Medi-Cal whenever long term care is needed. Even when proactive planning was not carried out however, we've been extremely successful at helping our clients qualify for, and obtain, Medi-Cal.
Committed to Helping You With All Your Long-Term Care Needs
We understand that trying to obtain the right kind of Medi-Cal is confusing and overwhelming. The unfortunate fact is that the Federal rules as well as California eligibility requirements are constantly changing. For the uninformed and inexperienced, going it alone often leads to Medi-Cal disqualification, penalties, loss of control and impoverishment. But it doesn't have to be that way.
Our California Medi-Cal Planning Lawyers are prepared to help you and your family navigate the long term care maze. We do this by avoiding common mistakes and implementing the best possible planning strategies. Indeed, when you hire us, we review every aspect of your financial and legal circumstances, plot a course of action to successfully move forward, utilize asset protection strategies such as irrevocable asset protection trusts, apply for the right type of Medi-Cal for our clients as well as interface with the Department of Health Care Services on our client's behalf, and then advocate for them under the Nursing Home Reform Act to make sure caregivers are providing the best possible care.