Medi-Cal Long Term Care Primer – Part 3 of 4

The second planning consideration for Medi-Cal Long Term Care Benefits (LTC) is called share of cost.

Once Medi-Cal LTC eligibility is established (See Part II), attention turns to share of cost. It is the co-pay requirement of Medi-Cal LTC.

Typically, a Medi-Cal LTC beneficiary must contribute their monthly income towards the cost of his or her care.  This usually includes Social Security, pensions, investment and rental income, among others.  Certain deductions are allowed, e.g., health insurance related premiums, and a personal needs allowance, currently $35.

For married couples, there is an additional protection when one of the spouses is not receiving Medi-Cal LTC benefits, commonly called the community spouse.  That spouse can have at least $2,981 of income each month in 2015.

With good planning that income figure can be obtained even if both spouses’ monthly income before Medi-Cal eligibility is below $2,981. In circumstances that require the community spouse have more than $2,981 per month in income, there are options available.

The good planning described above will generally require a court petition.  For this reason alone, it is critically important to work with an experienced, qualified elder law attorney who handles Medi-Cal cases since the other non-attorney, self-described Medi-Cal “experts” cannot file the needed court petition.  To do so would be a crime, the unauthorized practice of law.

A frequent problem that arises in Medi-Cal share of cost determinations is the maintenance of a home when an unmarried person receives Medi-Cal LTC benefits.  Since that person will only be allowed to keep $35 per month for his or her “personal needs’, that paltry amount is obviously not enough to pay for property taxes, insurance, utilities and other costs involved with the upkeep of a home.  An experienced, qualified elder law attorney can assist with planning strategies so that funds can be available to assist in protecting the home.

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Timothy P. Murphy

Timothy P. Murphy is an estate planning and elder law attorney whose practice emphasizes helping people to build, preserve and pass on their wealth. He works with his clients to accomplish their goals while avoiding unnecessary court proceedings and minimizing or eliminating exposure to death taxes.

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