Medi-Cal is a program that is only available to people who can prove that they have significant financial need. If you have Medicare coverage as a senior citizen, you would not need Medi-Cal at first, and you probably wouldn’t qualify, because the asset and income limits are very modest.
For an individual, the limit on countable assets is just $2,000.
In spite of the above, this program becomes relevant to a significant percentage of senior citizens, because Medicare will not pay for long-term care. People who are receiving help with their activities of daily living are receiving custodial care. Medicare will pay for medical treatment and convalescent care after surgery, but it will not pay for custodial care.
Medi-Cal will pay for long-term care. In a very real sense, Medicaid has become the de facto source of long-term care insurance in the United States. Most elder Americans who are residing in nursing homes are enrolled in the Medicaid program.
How do you qualify for Medi-Cal if you have never been financially needy? The answer is that you can divest yourself of assets by giving gifts to loved ones who would have otherwise inherited the resources after your passing.
This is typically referred to as a Medi-Cal spend down.
The spend down process is somewhat tricky, because there is a look-back period. In California, there is a 30 month look-back at the present time. You must complete your divestitures at least 30 months before you apply for Medi-Cal coverage, or your application will be denied initially.
Under federal guidelines, the states must seek recovery from the estates of seniors who were using Medi-Cal to pay for long-term care.
A bill was recently vetoed by California Governor Jerry Brown that would have limited recovery efforts to long-term care expenditures. As a result, the program can continue to seek reimbursement for a wide array of medical expenses.
Because of the expansion of the Medi-Cal program as a result of the Affordable Care Act, many more seniors are impacted.
When you are planning ahead for the future, you should be well aware of the lay of the land with regard to Medi-Cal recovery.
If you take the right steps, you can limit the tangible assets that comprise your estate, and there would be little to nothing left for the program to attach after you pass away.
Medi-Cal Planning Consultation
Most seniors are going to need long-term care at some point in time, and it is very expensive. As a result, the Medi-Cal program is relevant to a very significant percentage of California senior citizens.
If you would like to discuss things with an elder care professional, contact us through this page to set up a free consultation: San Jose CA Medi-Cal Planning.