MEDI-CAL COMMUNITY BASED ELIGIBILITY FOR PEOPLE 65 AND OLDER

Medi-Cal is California’s version of the Medicaid program that is funded by the state and federal governments.  The Community based Medi-Cal Benefits Program is a government program to help pay for medical needs for low income persons and others with limited resources and high medical bills for individuals are not in a nursing home.

NOTE: There is also Medi-CAL Long Term Care that helps pay expenses if the person is in a skilled nursing facility. THIS PROGRAM HAS DIFFERENT ELIGIBILITY REQUIREMENTS!! LA LAW Medi-Cal Attorney and Medi-Cal Specialists can help you with these requirements.

We will explain the nursing home program in our next LA LAW Center Blog or you call us for a free phone consult to make sure you know if you can qualify for Medi-CAL LTC. Call 818.241.4238.

For Medi-CAL Community Based Program basic qualifications requirements are as follows:

Although persons 65 years old and older with Medi-Cal also receive Medicare, the Medi-Cal program is not related to Medicare Insurance. Medicare is an earned benefit. Medi-Cal is a need-based program with limited amount of income and resources a person has that determines eligibility.

  1. If you are 65, blind or disabled and on SSI, you are automatically covered by Medi-Cal.
  2. I If you are 65, and your income is too high to qualify for SSI, you may still be eligible for Medi-Cal if:
    1. you meet the Community based Medi-Cal resource limits ($2,000 for an individual, $3,000 for a couple). This means this is the amount of assets you have available to you (bank accounts, autos, real estate, more than your home, etc.! LA LAW Staff can help you move other assets into a special Irrevocable trust and then you will qualify.
    2. you are aged 65 or older, blind, or disabled; and payments for your medical bills would leave you with less than the available “need standard” for your other living expenses;

There are other Community based Medi-Cal programs for special conditions for individuals. What are the Income Limits? California law has a fixed maintenance need standard for those who are living at home (not in nursing home).Basically, it is  the amount of monthly income California has set that a person(s) need for necessary monthly expenses, not including medical bills. This set amount is for a single elder (over 65) or disabled person is $600 per month; for an elder/disabled couple it is $934 per month, unless you qualify for the Aged & Disabled Federal Poverty Level Program.

For the Aged & Disabled Federal Poverty Level Program, starting April 1, 2016, an aged or disabled person with countable income at or below $1,220 or couples with an income at or below $1,645 (both subject to change in April 2017) could be qualified for the Aged & Disabled Medi-Cal Program and pay no share of cost. Qualified individuals must be aged 65 or older or disabled and not in long term care nursing facilities.

Basically, if the monthly income is higher than the above listed need standard, or above the aged and disabled level, the person will have a “share of cost” (kind of like a deductible) for your medical bills each month. Once the person pays or agrees to pay the monthly “share of cost” towards the person’s  medical bills, the person will use their  Medi-Cal card to pay for the rest of Medi-Cal covered medical services each month.

This can be helpful for anyone with major medical bills.  The rules are different for individuals are under 65.  We are happy to help you understand your options.  Call us at 818.241.4238.

WHY DO YOU NEED TO HIRE AN ELDER LAW ATTORNEY???

We often get questions about why people should hire an Elder Law Attorney. Recently one of our clients took the time to recap his experience with us on YELP, as we helped him through the LifeCare Process and I thought I would share this with you. This is the best thing I have seen that shows why you should call our Burbank firm! (818)241-4238.
YELP Review 5 Stars 2/2/2017 from LA LAW Center client…

I searched far and wide and interviewed countless attorneys to help me handle all my affairs with my elderly mother, and with this group of people at L.A. Law Center, I hit the jackpot.  They helped me with everything and are still helping.  Joe & Kathy, and their team (especially Diana who is outstanding too) This LAW CENTER IS THE BEST, HANDS DOWN, TAKING CARE OF EVERYTHING FOR ME AND MY MOM FROM BEGINNING TO END!  My mom had 4 strokes since she was 69 years old, and I brought her down to care for her at my home when she was 85 years old roughly 4 years ago.  She had SOME funds which made her ineligible for Medi-Cal initially,but I could not care for her at my home initially expense wise unless she could join Medi-Cal and make her eligible for some help from IHSS (IN Home Supportive Services). This senior help law group had a completely legal way of opening up a Medi-Cal asset protection trust  for my mom so the money she did have was transferred legally into that trust, (which Joe wrote) and immediately afterward they took care of getting her approved for Medi-Cal.

Kathy (his wife), is a licensed and experienced senior advocate.  Kathy has knowledge of how Medi-Cal works and is also an authorized Medi-Cal placement representative, as well as a licensed Triage director, and Certified Senior Advisor. She walked me through how to transfer the money and she did the paperwork and took me through it all step by step.  (And Diana was instrumental in handling all the paperwork and dealing with the Medi-Cal representatives.  It would have been insane for me to even attempt doing that myself) (They have never failed to get someone approved by the way) And then, once my mom was approved for Medi-Cal, they advised me on how to sign my mother up for In Home Supportive services where I received help for almost 2  years so I could care for my mother at home which were her wished and not be forced to put her in a facility immediately.  But Kathy’s service didn’t stop there, their services cover the lifetime of my mother, and we did this all in advance knowing at some point my mom would have another stroke event (which she did recently) and at some point facility care would be needed temporarily or permanently if she had too many needs for me to take care of her at home even with help.

So in the last 2-3 months, my mom’s most recent stroke put her in the hospital again, and then rehab which medicare covered up to a point.  Kathy guided me through this the entire time.  And when medicare (and Kaiser) stopped their rehab support, my mother was in no condition to come home safely, and this is where Kathy’s knowledge came in handy again, advising me in finding the best facility because after medicare stopped paying, she knew the law was that if I could not care for her at home, they would have to keep her in the long term care unit at their facility and transfer her to her Medi-Cal coverage.  And the facility did everything to try and kick her out but Kathy kept me strong to fight them and stand up for my mom’s rights.  Because when the LA Law Center agreed to take us on – Kathy became my mom’s personal legal advocate (in addition to me) and my mom is now being cared for and very happy in an outstanding facility which I never would have been able to make happen without her knowledge of what our rights were. (And as a side note – Kathy did this for us with a broken foot healing at home and recovering from that awful flu for a month – while I texted her these extremely long texts multiple times a day for about 30 days straight – during this entire last stroke episode – from hospital to rehab – to finding the best facility in Los Angeles Country to dealing with the case workers for the hospital and the facilities who are trying to do nothing but get my ailing mom out as fast as they can so they could make more money.  Kathy did this for me (with Diana’s help) – from her sick bed because it was crisis time.

Joe, and Kathy, and Diane, and the rest of their legal team, took my mom on after our first meeting with them, to make sure she was taken care of for the rest of her life.  That is what their service provides, overseeing my mom and helping me (her eldest son and power of attorney) to give her the best and most loving care possible.  I am eternally grateful to these people.  They are loving and caring and have their comprehensive help and legal expertise down.  It’s what they do.  I was recommended to them by another attorney who said if you want a group of people who will help you with your mom from beginning to the end.  This is the only group that provided the most comprehensive service.  And at EXTREMELY reasonable rates.  Read the other reviews and everyone has a slightly different situation but a similar recommendation,  These people are just the best.  I am so blessed and grateful to have found them.  Their help has been invaluable to me, and most importantly my beloved mother. Thank you,,Thank you, Thank you.

CALL US AT (818)241-4238 for a free phone or office consultation.