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Medi-Cal Planning

Medi-Cal is a combined federal and California State program designed to help pay for medical care for public assistance recipients and other low-income persons. Although Medi-Cal recipients often receive Medicare, the Medi-Cal program is a separate program from Medicare.

Medicare is a federal program that will only cover long term care if you came to a nursing home directly from a hospital and require skilled nursing, physician or rehabilitation services every day. Being in a long term care facility merely requiring “custodial care” – e.g., help with personal care, with daily activities or with taking medications – is not enough for Medicare to pay your nursing home bills. Medi-Cal will pay most (if not all) of the high cost of nursing homes provided you are qualified. Because it is a need-based program, Medi-Cal recipients must pass certain eligibility requirements.

In order to qualify for Medi-Cal, the recipient must demonstrate that he or she has limited resources available. In determining eligibility, Medi-Cal classifies property owned by an applicant as exempt and non-exempt. Owning exempt property will not affect eligibility. Owning too much non-exempt property will preclude eligibility. The process of Medi-Cal planning involves redistributing assets so that they qualify as exempt property for the determination of eligibility for Medi-Cal. In addition to the asset analysis, eligibility is also based on income. A recipient may only earn a limited amount of income in order to qualify for Medi-Cal.

This explanation of Medi-Cal is simplified to provide you with a basic awareness of the program. The most important thing to recognize is that a surprising number of people could qualify for Medi-Cal if they would only do some Medi-Cal planning. 



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