How to qualify for MediCal for nursing home care and keep your assets

To qualify for Medi-Cal, one must not have more than $2,000 of countable assets and $35 in income each month. But this rather scary figure leaves out the rest of the story, which is considerably less frightening.

First, the asset rules. The $2,000 limit is for “countable” assets only, and countable assets do not include your home (and furnishings/contents within your home), your car, your retirement (IRA, 401k – though there are special rules for these so don’t ever assume you can properly plan on your own with an article about Medi-Cal basics) and certain other assets. In addition, if you are married, your spouse can keep up to $119,220 (in 2016) in countable assets.

In terms of income, the spouse of a married applicant can keep ALL income in his/her name and can even receive income from the Medi-Cal applicant spouse if the well spouse’s income is below about $3,000. The rest of the income of the applicant spouse goes towards their “share of costs” for the nursing home care, and is likened to a copay or deductible.

But that’s not all. First, there are legal ways to transfer your assets to protect them, in effect keeping more than the stated limits (there are pros and cons to these kinds of arrangements, but my clients pretty uniformly consider the cons to be far less difficult than paying $10,000 or more a month on nursing home care). This kind of Medi-Cal planning is quite common even though it’s not very well known. In addition, it can be possible to ask the court to increase the limits in certain situations. There are a lot of available options for qualifying for Medi-Cal if you have more than $2,000 in assets – or more than $119,220 – even if your assets and estate are substantially more than these limits.

Give us a call at 925.307.6543 or click here to make an appointment directly using our online scheduling. We have offices all over the Bay Area for your convenience, with our main office in Dublin and satellite offices in Oakland, Walnut Creek, San Francisco, San Mateo, Palo Alto, Sunnyvale, San Rafael and Antioch.

What’s the difference between Medicare & MediCal for nursing home care?

Medicare and Medi-Cal are different governmental programs, both of which can be used to pay for nursing home care. Medicare is health insurance that is federally-funded and available to those 65 and over or are disabled. There are no income or resource requirements for Medicare. Medicare will pay for up to 20 days of skilled nursing home care after three days of hospitalization. Medicare will also pay for additional nursing home care days past day 20, up to a limit of 100 days, with a daily co-pay and only if the individual continues to show improvement in the condition that sent them to nursing care. Anyone in skilled nursing home care past 100 days must either pay on their own for the care (“private pay”) or apply for Medi-Cal. Once approved, Medi-Cal will pay for skilled nursing home care indefinitely, regardless of whether the patient improves or not. Monthly expenses for skilled nursing home care averages around $8,000 monthly in California, but very often in practice can cost between $10-15,000 monthly.

If you think it’s confusing, you’re not alone. Getting older is not for the weak! We’d love to help you out if you need more information. Give us a call or schedule a free consultation today!

Mom headed to a nursing home? How you can qualify for MediCal to pay for it AND keep your assets

It’s a common misconception that one cannot have any assets to obtain Medi-Cal benefits in California. The rules that most of us know about (you can’t have more than $2,000, for example) leave out the rest of the story as well as the options available for you and your family. In fact, the reality is quite a bit more complicated, but it’s this complexity that opens the door for planning. If you’re paying for a skilled nursing facility with private money and assets, then the likelihood is high that you could benefit from planning and reduce (or eliminate!) your share of costs as well as protect the remaining assets from Medi-Cal recovery. At $10-15,000/month or more for skilled nursing care, what do you have to lose to find out if you can stop the bleeding of assets? We offer a complimentary analysis of your situation for Medi-Cal eligibility. If you download and fill out this form, we will get back to you within 48 hours with a preliminary report on how we can help you qualify for Medi-Cal benefits. Click here for the FREE Medi-Cal Eligibility Form.

Or just use the link to the right to schedule your free consultation at one of our Bay Area offices.