Medi-Cal and Disability Planning

San Diego Elder Law Center

Medi-Cal and Disability Planning

Help your loved one get quality nursing home care, while saving family assets. “Don’t be fooled by the myth of the “Medi-Cal Spend Down”.

Medi-Cal is California’s program for administering federal Medicaid funds. Medi-Cal has several different programs. The most misunderstood is “Long Term Care” coverage. Most people first hear about Medi-Cal Long Term Care coverage when a family member or loved one is hospitalized then discharged to a rehabilitation or skilled nursing facility. For the elderly, Medicare will pay for this extended care for a while…but not long. The maximum period Medicare will pay for is 100 days, but most families will find themselves receiving a notice of termination of Medicare long before 100 days. For those who do not have long term care insurance, the choice then becomes to pay it themselves, or apply for Long Term Care Medi-Cal. Those who must pay from their own funds will find that the costs are in the neighborhood of $5,000.00 per month and up. For a married couple, few could afford this for long without seriously impacting the financial security of the at-home spouse. Both married and unmarried individuals also worry as the estate they intended to pass to their children or heirs is rapidly eaten up by nursing home bills.

The clear alternative is the Long Term Care Medi-Cal program. Medi-Cal will pay for 100% of nursing home expenses for those who qualify. Some may need to pay a partial “share of cost,” but many will not. Even those with a relatively high share of cost pay far less than the private pay rate for a nursing home.

There is an unfortunate amount of misinformation and misunderstanding about how to qualify for Long Term Care Medi-Cal. Most people think they must spend their assets down to less than $2,000 to qualify for Medi-Cal. This is almost never true. There are many assets and types of funds that are considered “exempt” and not counted in the qualification process. There is no penalty if you move assets that are not exempt into assets that are. There are also other substantial allowances available for those who are aware and request them. Do not expect Medi-Cal eligibility workers to properly educate you about this!

With our assistance, the majority of those who consult with us can qualify for Long Term Care Medi-Cal, legally preserving most, if not all, of their assets for themselves and their loved ones. We can help you minimize the “share of cost,” and avoid recovery claims by the State upon the death of the Medi-Cal beneficiary. The rules concerning Medi-Cal qualification are complicated. Many thousands of your family’s dollars may be at stake. Before incorrectly assuming you will not qualify for Medi-Cal, please consult with us. If you wish, we will handle the entire Medi-Cal application process and any appeals as well.

Special Warning about "Medi-Cal Planners"

More on Medi-Cal “Myths”

San Diego Elder Law Center

Philip P. Lindsley, JD, CELA
Certified Elder Law Attorney

(619) 235-4357

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