Medi-Cal Planning Attorney
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.
We assist seniors and those who love them throughout Los Angeles and Ventura
counties 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) 306-2500 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.