A Medi-CAL Long Term Care applicant must be in a skilled nursing home and be 65 years of age, blind or disabled to receive Long Term Care Medi-Cal benefits.
A proper legal strategy in Medi-Cal eligibility planning will not only qualify our clients for Medi-Cal benefits while preserving assets in an Irrevocable Trust, but also provide asset protection from future Medi-Cal estate recovery (including the family home). LA LAW Center has great experience in successfully preparing and implementing effective asset protection plans that meet eligibility rules and provide estate recovery protection.
ASSET LIMITS TO QUALIFY
An unmarried applicant must have no more than $2,000 (for 2019) in “non-exempt” assets.
A married couple with an applicant has the following assets limits:
- The well spouse can have $126,420 (for 2019) in “non-exempt” assets.
- The Medi-Cal applicant must have no more than $2,000 (for 2019) in “non-exempt” assets.
Medi-Cal defines the following assets as “exempt” and their values are not counted in determining an applicant’s eligibility as listed above:
- One vehicle each
- Residence (other properties are counted and can be moved to qualify)
- Life insurance policies with NO CASH VALUE
- Burial plots
- Prepaid Irrevocable Pre Needs Burial Contracts
- Household goods and furniture
- Qualified retirement accounts (IRAs, 401Ks) there are some restrictions
It is important to have an experienced elder law attorney help you set up Medi-Cal qualification plan with the existing and changing Medi-Cal regulations. Also, it is important to know the potential tax ramifications that Medi-Cal planning might trigger. Advanced planning is recommended as the laws may be changing soon and the transfers we can do now will be grandfathered in and will be allowed.
MEDI-CAL ESTATE RECOVERY
Medi-Cal keeps track of the total amount paid out for nursing home care to the person getting Medi-Cal benefits and will attempt to recover that amount from the beneficiary’s remaining estate.
LA LAW Center staff will guide you in protecting any recovery as most asset will not be in person’s name that has passed away most likely avoid potential Medi-Cal estate recovery.
Although an applicant’s income is not an eligibility factor for Long Term Care Medi-Cal, Medi-Cal does review an applicant’s income to determine the applicant’s monthly co-payment obligation (“share of cost”) to the skilled nursing facility. The formula used to determine an applicant’s “share of cost” has many variables and often allows the applicant’s spouse to retain a large portion of the applicant’s income. With proper planning it may be possible to reduce one’s “share of cost.”
Our firm is often able to reduce a patient’s “share of cost” through the utilization of various innovative techniques developed over the course of our nearly 20 year practice.
MEDI-CAL ESTATE RECOVERY
Medi-Cal keeps track of the total amount of benefits it pays out over the lifetime of a Medi-Cal beneficiary and attempts to recover that amount from the beneficiary’s remaining estate. Medi-Cal may only potentially recover from the assets that the Medi-Cal beneficiary has an ownership interest in at the time of their passing, and only after the death of the Medi-Cal beneficiary’s spouse. Thus, the Medi-Cal beneficiary’s spouse will have unrestricted use of the assets for the remainder of their life. Fairly recently in 2017, the Medi-Cal recovery regulations where overhauled to the advantage of Medi-Cal beneficiaries.
Our firm will carefully review your financial assets and strategize in order to minimize or, more than likely, completely avoid potential Medi-Cal estate recovery. A proper Medi-Cal eligibility plan will not only qualify an individual for Medi-Cal benefits (thereby preserving assets), but also provide asset protection from future Medi-Cal estate recovery (including protection of one’s home). Our firm is highly qualified in preparing and implementing effective asset protection plans that address not only eligibility, but also complete estate recovery protection.
COURT PROCEEDINGS AND ADMINISTRATIVE
FAIR HEARINGS TO QUALIFY FOR MEDI-CAL BENEFITS
For married couples, a “3100 Court Petition” or “Administrative Fair Hearing” are often valuable tools used to significantly increase the standard $126,420 Medi-Cal eligibility limit for countable assets. Additionally, a “3100 Court Petition” may be used to reduce or eliminate the “share of cost” monthly co-payment obligation and to transfer all assets to the Medi-Cal beneficiary’s spouse thereby eliminating Medi-Cal estate recovery.
Many are not aware of these powerful tools available to achieve Medi-Cal qualification. In fact, many elder law attorneys are not familiar with these options. Since 2000, Sean D. Ethington has successfully utilized both of these options on numerous occasions and is among the leaders in developing the the “3100 Petition” strategy.
We specialize in preparing legal Medi-Cal qualification plans for emergency situations (includes client in hospital or skilled nursing home looking at Medicare 100 days running out!). Very quickly, once we see an overview of assets, we can create and plan and timing of how quickly we can get our clients qualified for Medi-Cal. Medi-Cal can be made effective the first day of the month that assets are reassigned into an Irrevocable Trust (or possibly even three months retroactively if assets just need to be moved between spouses).
You will not be sorry to call us about Medi-Cal Long Term Care Planning! The sooner the better as we anticipate the laws changing as restricting asset transfers. Our rule of thumb is:
“IF YOU THINK YOU MAY NEED LONG TERM CARE IN THE NEXT 5 YEARS, CALL US NOW!”
We offer free consultations. Call (818)241-4238.