Basic California Medi-Cal facts
What the California Medical Assistance Program covers
Long-term care Medi-Cal is a joint federal / state program for people whose health problems require 24-hour care in a skilled nursing home. In California, if the person qualifies, Medi-Cal pays for the nursing home and the medical care needed while there, including costs for medicine and supplies, physical therapy, special beds, and more. It pays as long as the person’s health requires skilled nursing home care. If a person qualifies for Medi-Cal but only needs assisted residential care rather than skilled nursing home care, Medi-Cal will not pay for the facility but will pay for some or all of the individual’s medical needs, if the qualified person’s income is not sufficient to cover those needs.
California Medi-Cal income limits & Medi-Cal asset limits
Medi-Cal only pays if the “countable” (liquid) assets of the ill person and their spouse are below certain income & asset limits. It also limits how much income the ill person can keep; the rest of the ill person’s income must be paid towards the nursing home bills before Medi-Cal will pay. Because nursing homes are very expensive, and these asset limits are very low, people can become impoverished before California Medical Assistance Program starts paying.
Converting “countable” to “exempt” assets
An ill person and their spouse can avoid impoverishment by using their “countable” (liquid) assets to pay off bills and loans, buy an income annuity that complies with Medi-Cal law, pay for repairs and other necessary expenses, and buy assets “exempt” from Medi-Cal accounting. For more information, please see, Medi-Cal & Protecting Assets, on this website
Increasing spouse’s income
The spouse can also petition to have all or part of the ill person’s income given to the spouse, or to keep more of the “countable” assets, so that the spouse is not impoverished.
When to Take Steps to Qualify for Medi-Cal
Countable assets can be converted to exempt assets before or at any time after the ill person has entered a nursing home. If the asset conversions are handled properly, and the Medi-Cal forms are completed properly, Medi-Cal is usually granted within 45-90 days.
Steps after Medi-Cal Application is granted
Medi-Cal considers its payments to be loans, and will eventually attempt to collect them from the ill person’s estate. There are legal steps that, if taken before the ill person dies, can pass those assets to the children and other family members where they are immune from later collection by Medi-Cal. To preserve the ill person’s Medi-Cal benefits, to make sure the transfers are not later declared invalid by a court, and to avoid unpleasant tax consequences, it is crucial that the transfers be done exactly as the law requires and that all legal documents be properly prepared and, where needed, served and filed. Only an experienced, licensed California attorney is qualified to handle these legal steps for you. Medi-Cal lawyers with experience in these areas will make the planning process even smoother.
Our Medi-Cal Services
The skilled, experienced attorneys of San Diego Law Firm handle all aspects of California Medi-Cal eligibility qualification and asset protection. We serve all of California, including San Diego (where our offices are located), Riverside, Imperial, and Los Angeles counties.
Our Medi-Cal Lawyers
Our goals are to help the ill person obtain the maximum Medi-Cal benefits available while protecting the assets they accumulated over their lifetime. Although we often work closely with family members, our legal duty of loyalty requires us to always follow the wishes of the ill person and their spouse, if they are married.
If someone in your family is facing the high costs of nursing home care, and needs to qualify for Medi-Cal to protect the ill person and/or their spouse’s finances, we can:
- Evaluate your finances and consult with you and your
family about meeting Medi-Cal’s eligibility requirements.
- Recommend specific asset-management steps to qualify for Medi-Cal while preserving as many assets as possible, and as much income as possible for an at-home spouse, given your particular situation.
- Advise you on how annuities and gifts may affect Medi-Cal eligibility, and assist you with these as needed.
- Advise you on when selling or trading “countable” assets may result in additional income or property taxes, and on the steps to avoid or minimize these taxes.
- Prepare legal documents needed and assist you where needed to convert countable assets to exempt assets.
- Handle court filings and appearances for conservatorship for Medi-Cal planning if the ill person is incapacitated.
- Prepare the Medi-Cal application for you.
- Deal directly with Medi-Cal for you, while your application is pending.
- Prepare all legal and administrative papers, and appear for you at all hearings.
- Prepare a court petition for an increased income allowance for the spouse, where needed, and appear in court to argue on your behalf.
- Correct mistakes made if you previously applied but were rejected by Medi-Cal.
- Advise on and assist with transfers and document preparation needed to move assets beyond Medi-Cal’s post-death collection procedures.
Ready to talk about Medi-Cal eligibility? We’re here to help.
Click links below for more Medi-Cal information, download our free guide, or call us at 619-794-0243 to make an appointment for help with Medi-Cal planning. We look forward to helping you.