Medi-Cal Eligibility Planning to Qualify For Medi-Cal Benefits

There are three very important areas to consider in developing a comprehensive Medi-Cal plan: Eligibility Planning - to qualify for Medi-Cal benefits;

1.Income Planning - to reduce or eliminate a Medi-Cal beneficiary's monthly share of cost co-payment; and
2.Medi-Cal Recovery Planning- to reduce or completely eliminate Medi-Cal recovery against the beneficiary's estate.
Our office will carefully review your assets, income and estate planning documents to develop a comprehensive Medi-Cal plan tailored to your specific situation. We typically offer our clients several alternative strategies and thoroughly review each strategy with our clients so that they can make an informed decision.

What Is Medi-Cal?
Medi-Cal is the state of California's version of the federal Medicaid program that provides additional health insurance for qualified individuals who are 65 years of age, blind or disabled. Medi-Cal is particularly helpful for individuals who are residing in a skilled nursing home that have exhausted their Medicare skilled nursing home coverage. While Medicare may cover the first 20 days of skilled nursing home expenses, coverage for days 21 through 100 requires a co-payment, and is only available if the patient continues to show improvement in his or her condition. On the other hand, Medi-Cal will continue to pay for skilled nursing home expenses indefinitely, regardless of whether or not the patient continues to show improvement.

Unfortunately, many people are misinformed about the eligibility criteria Medi-Cal uses to determine eligibility. Such misinformation is likely due to the ever changing and complicated Medi-Cal regulations. Despite what you might have heard, you do not have to be destitute in order to qualify for Medi-Cal benefits. With the guidance of a knowledgeable elder law attorney, it is legal to implement various planning techniques in order to qualify for Medi-Cal benefits.

Our law firm is experienced in developing and implementing various Medi-Cal planning techniques to quickly qualify an individual for Medi-Cal benefits and to minimize or completely eliminate any state recovery for benefits received. Medi-Cal planning is our passion and we take great pride in developing sound planning options for our clients tailored to their unique circumstances.

Standard Eligibility Limits For Long Term Care Medi-Cal Benefits

The applicant must be 65 years of age, blind or disabled in order to receive Medi-Cal Long Term Care benefits. A single applicant may not have more than $2,000.00 (for 2008) in non-exempt assets, while the spouse of a married applicant is allowed $104,400.00 (for 2008) in non-exempt assets.

Medi-Cal classifies certain assets as exempt and their values are not used in the determining an applicant's eligibility. The following are the major assets considered exempt by Medi-Cal in determining eligibility:

•Principal Residence
•Certain Life Insurance
•One Vehicle
•Household Goods
•Most Qualified Retirement Accounts
•Burial Plots
It is important to understand that the above are standard Medi-Cal eligibility limits. For married applicants, it is possible to significantly increase the standard $104,400.00 limit.

Again, a Medi-Cal eligibility plan should only be carried out under the guidance of a knowledgeable California elder law attorney familiar with Medi-Cal regulations.

Although an applicant's income is not an eligibility factor, Medi-Cal does review an applicant's income to determine the applicant's monthly co-payment (share of cost). 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.

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 recover from the assets that the Medi-Cal beneficiary has an ownership interest in at the time of their passing, and only after the Medi-Cal beneficiary's spouse also passes away. Thus, the Medi-Cal beneficiary's spouse will have unrestricted use of the assets for the remainder of their life.

Medi-Cal Services Provided By Our Law Office
We understand that Medi-Cal planning can be an emotional undertaking for you and your family. Our office will make the Medi-Cal process as easy as possible by providing the following services:

•Preparation and explanation of alternative Medi-Cal planning strategies available for your specific situation;
•Implementation of the Medi-Cal qualification strategy of your choice;
•Preparation of the Medi-Cal application forms;
•Our office will deal directly with Medi-Cal on your behalf through completion of the application process;
•Preparation of estate planning documents (if applicable);
•Assist you with your overall estate plan; and
•Preparation of all documents necessary to reduce or eliminate Medi-Cal recovery (if applicable).
A Word of Caution
Medi-Cal regulations are constantly updated and changed. Medi-Cal planning should only be done under the supervision of an elder law attorney familiar with Medi-Cal. Certain transfers of property can have significant tax ramifications that should be discussed with your attorney. Furthermore, improper transfers can disqualify a Medi-Cal beneficiary and result in a significant period of ineligibility for Medi-Cal benefits.