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Horizon Elder Law & Estate Planning Blog

Tuesday, July 17, 2018

Seven Do's and Don'ts of Medi Cal Planning

California administers federal Medicaid funds through its Medi-Cal program. The agency administers several different types of programs, including Medicaid Long-Term Care. For many individuals and families, the cost of long-term care can be overwhelming. With many nursing homes charging between $8,000 to $10,000 a month for skilled care, the only option to pay for long-term care is with Medicaid. However, if you are not very careful, you or your loved one may not qualify for Medi-Cal when you need long-term care.

Below are seven Do’s and Don’ts for Medi-Cal planning that our California Medi-Cal planning lawyer believes each family needs to know to avoid mistakes and errors that could result in a denial of benefits.

Seven Things You Need to Know About Medicaid Planning in California

  1. DON’T rely on Medicare to pay for long-term care. Medicare coverage pays for 100 days of skilled nursing care per illness. Sadly, Medicare does not pay for long-term care and, in some conditions, it can be very difficult to obtain coverage for the 100 days Medicare should cover.

  2. DO understand the intent of the Medi-Cal program. Medi-Cal is not an entitlement program such as Medicare. Medi-Cal is intended to benefit low-income or “impoverished” individuals. However, many middle-class individuals can qualify for Medi-Cal benefits with the help of an experienced California Medi-Cal planning lawyer who understands the eligibility guidelines for long-term care benefits from Medi-Cal.

  3. DON’T procrastinate – talk to a California Medi-Cal planning lawyer now. You need to plan for long-term care now to gain the most benefits from Medicaid planning. When you apply for Medi-Cal benefits, the office reviews your financial transactions for 30 months before your application. If you have transferred any non-exempt property, you may be ineligible for benefits. While you might qualify for Medi-Cal long-term care in the future, your period of ineligibility for transfers could be a problem if you need immediate nursing home care. Consulting a California Medi-Cal planning lawyer can help you avoid making transfers that will prevent you from qualifying for payment of long-term nursing home care.

  4. DO include your spouse in Medi-Cal planning. There are special rules regarding spouse’s income and assets when only one spouse requires skilled nursing or long-term care. Therefore, you need to include your spouse when meeting with our California Medi-Cal planning lawyer to discuss how to take advantage of special provisions for spouses.

  5. DON’T blindly spend down assets. As stated above, you could be penalized if you spend down or transfer non-exempt assets within 30 months of applying for long-term Medi-Cal. However, even if you believe you will not need nursing home care for at least 30 or more months from now, you should still consult an experienced attorney to ensure you are taking steps that are in your best interest. There are several strategies for Medicaid planning that do not involve getting rid of all assets or causing your family to become impoverished.

  6. DON’T forget to include estate planning with Medicaid planning. Medi-Cal has the authority to seek reimbursement for payment of long-term care from your estate after your death. However, there are several ways to protect your estate from the Medi-Cal recovery laws. Working with a California Medi-Cal planning lawyer can help you protect your assets before, during, and after the need for long-term nursing home care.

  7. DO consult with a California Medi-Cal Planning Lawyer. Medicaid planning can be a complex undertaking that requires the guidance and assistance of a California Medi-Cal planning lawyer. A simple, innocent transfer can result in a lengthy ineligibility period. Likewise, failing to protect assets could result in your heirs losing money and assets to Medi-Cal after your death. Contact our office at Horizon Law to discuss your situation and learn more about how we can help you protect your assets and ensure funds are available from Medi-Cal if you or your spouse needs nursing home care.


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