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Horizon Elder Law & Estate Planning Blog

Friday, May 11, 2018

Debunking Medi-Cal Myths

Do I need to spend down my assets in order to qualify for Medi-Cal benefits?

Medi-Cal is a federal and California state program that helps families to pay the costs of long term nursing care. With rising healthcare costs, the average family can simply not afford to pay for nursing home care when a loved one reaches the point that he or she needs around the clock care. Unfortunately, many myths surround the Medi-Cal program which may lead some individuals to not apply and others to spend their savings before seeking benefits. Our California Medi-Cal planning attorneys debunk some of the myths surrounding the Medi-Cal program below.

The Benefits of Medi-Cal

Medicare will only cover the costs of nursing home care for a maximum of 100 days, often stopping payments far sooner. Those without long term care insurance will then be forced to go home without the care they need, pay the costs of nursing home care on their own, or seek long-term Medi-Cal coverage. With most nursing home facilities in California charging $8,000 per month, few families can get by without long term care coverage.

Medi-Cal will cover up to 100 percent of nursing home expenses for as long as needed for those who qualify. Medi-Cal offers elderly individuals the care they need without bankrupting a family, but qualifying for Medi-Cal is not always easy.

Medi-Cal Eligibility

To be eligible for long term care through Medi-Cal, the individual applying must be expected to live longer than 30 days at a skilled nursing home facility. The applicant must be unable to complete basic tasks like bathing, mobility, dressing, taking medication, and more. Apart from physical qualifications, an applicant must meet asset and income qualifications.

Single individuals need to have no more than $2,000 in countable assets. Married couples where one spouse remains at home can have up to $120,900 in countable assets. For income, patients will pay a share of the cost based on their income after deduction of some expenses.

The Spend-Down Myth

Many people look at the asset limits for Medi-Cal and assume that they either should not bother applying because they have too many assets or must spend down their assets in order to qualify. However, this myth fails to account for the fact that many assets are not counted towards Medi-Cal limits. For example, exempt assets include your primary residence, IRAs, pensions, annuities, and more. There are many legal options that can allow Medi-Cal applicants to preserve their assets while still receiving benefits. Consult with a Medi-Cal planning attorney for more information.


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