Medi-Cal is California’s version of Medicaid, which provides financial help with healthcare expenditures to people with limited incomes and few resources. While many know Medi-Cal as a program to help those who have financial trouble, Medi-Cal is also one of the primary payers of nursing home bills for seniors. A nursing home is simply so expensive that even people with a lot of money and assets cannot afford the costs without assistance.
If you are going to rely on Medi-Cal to cover any of your medical costs, you need to know what Medicaid estate recovery rules mean to you. If you want to make sure that Medi-Cal will cover your nursing home costs when you need to get care, you also need to understand the rules and create a comprehensive Medicaid plan.
Northern California Center for Estate Planning & Elder Law is here to help. If you live in Sacramento, Roseville, Davis, and surrounding locations, give us a call at 916-437-3500 for personalized assistance creating a plan to qualify for Medi-Cal, get benefits, and protect your assets. We can also answer questions including:
- Why is Medi-Cal Planning Necessary?
- What Should Be Involved in Medi-Cal Planning?
- How can a Northern California Medi-Cal Planning Lawyer Help You?
Why is Medi-Cal Planning Necessary?
While California expanded eligibility for Medi-Cal under the Patient Protection and Affordable Care Act, there are still both income and resource limits which restrict who can qualify for benefits. This means if a senior has worked his or her whole life to build up a nest egg, the senior could be disqualified from Medi-Cal coverage because his or her resource levels are too high.
When a senior needs to go into a nursing home, disqualification from Medi-Cal can mean being forced to pay out-of-pocket. This is because Medicare covers a nursing home only for skilled care and only for a limited time; it does not cover ongoing daily custodial care. Nursing homes cost a fortune, and a senior could go through a life savings in a matter of months. Medi-Cal would then pick up the tab for nursing care, only after a legacy is gone.
With a Medi-Cal plan completed as early as possible, assets can be protected so a senior can qualify for Medi-Cal without spending down those important assets. This means a legacy is kept safe and heirs can inherit while Medi-Cal picks up the cost of nursing care sooner.
Medi-Cal planning is also important because the federal Medicaid program requires estate recovery to recoup certain Medicaid spending. If Medi-Cal pays for bills and you are subject to estate recovery, a claim could be made on your estate to get back the money spent for your care. This means your heirs could end up losing assets anyway.
What Should Be Involved in Medi-Cal Planning?
Medi-Cal planning generally involves the creation of a trust, the strategic transfer of property, and the strategic structuring of ownership so assets will not disqualify you from Medi-Cal coverage and so assets cannot be taken as part of the estate recovery process.
Medicaid has a five-year look back period applicable when applying for nursing home coverage, so a transfer of assets as part of Medicaid planning can result in a time of disqualification when no benefits are available. The formula used to determine how long you are disqualified from coverage takes into account the value of assets transferred and the average monthly cost of a nursing home.
Because of the five-year look back rule, beginning Medi-Cal planning early is strongly advised. The sooner you take steps to structure ownership of your assets so the assets won’t count in determining eligibility, the more of your assets you can protect. If you create your plan, fund your trust and complete strategic transfers at least five years before you have to go into a nursing home, you should be able to protect virtually all of your property while getting Medi-Cal to pay for the care you require.
How Can a Northern California Medi-Cal Planning Lawyer Help?
Northern California Center for Estate Planning & Elder Law provides comprehensive advice with Medi-Cal planning to clients in Sacramento, Roseville, Davis and surrounding areas. We believe firmly that you should get the help with medical care and nursing home costs that you need without having to lose a lifetime of assets that you have worked so hard to acquire. To create your plan so you can leave a legacy for your loved ones while getting your care costs covered, give us a call at 916-437-3500 or contact us online today.