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Medi-Cal

Q: Is Medi-Cal the same as Medicaid?
A: Yes, Medi-Cal is California's version of Medicaid.

Q: Does Medi-Cal provide nursing home benefits?
A: Yes, Medi-Cal provides nursing home benefits if you do not have the financial resources to pay for them yourself. You must however provide a detailed financial snapshot of all of your assets to qualify.

Q: Does Medi-Cal provide home care benefits for custodial care?
A: No.

Q: I have heard people say that Medi-Cal is welfare. What is your opinion on this?
A: Medi-Cal provides health coverage to people who cannot afford to purchase their own coverage and to dependent children, etc. Medi-Cal also provides nursing home coverage to people who cannot afford the cost of a nursing home. Medi-Cal is an entitlement program that is paid for with your tax dollars and you are entitled to its benefits if you qualify financially. Whereas Medicare is an illness based healthcare program, Medi-Cal is a financial need based program.

The problem with these programs is they are not equitable, and how much the federal government pays is largely based on what your illness is. In my opinion it is not welfare since you have paid for the benefits with your tax dollars and you have no control over the illness you contract. i.e.nursing care may be required for years as the result of Alzheimers disease, Parkinson's disease or a severe stroke. Although all three illnesses are caused by medical conditions, long term care for these conditions is not covered by Medicare.

Q: If a multi-millionaire required hundreds of thousands of dollars in cancer treatments, would Medicare cover a substantial part of his treatment costs?
A: Yes. Cancer is an illness covered my Medicare.

Q: If I contract Alzheimer's, Parkinson's or have a debilitating stroke that requires custodial care in a nursing home for years and years, will Medicare cover my costs?
A: No. Because you have contracted an illness that is not covered by Medicare, it will not pay for your long term care expenses. You must either pay for them using private insurance or spend down your assets until you can qualify for Medi-Cal.

Q: If I am in a nursing home that I like, that I pay for from my savings, can the facility force me to leave when I run out of money and must go on Medi-Cal?
A: No. The facility cannot force you to leave because you can no longer pay?

Q: What are the basic requirements to qualify for Medi-Cal as a married person?
A: You may keep 1 house, 1 car, 1 wedding ring and 1 burial plot. You may also keep your personal possessions and $1,500 in cash value life insurance. The equity in your home cannot be more than $500,000 and you must spend down your savings to preset qualification limits.

Q: If I am married and my spouse enters a nursing home how much of my savings am I allowed to keep?
A: As the stay at home spouse, you are allowed to keep up to $109,560 in 2009 ($104,400 in 2008). Any money in excess of this amount must be spent-down to this amount before your spouse can qualify for Medi-Cal benefits.

Q: How much savings am I allowed to keep to qualify for Medi-Cal as a single person?
A: As a single person you must spend down your savings to a maximum of $2,000.

Q: Can Medi-Cal take my home if I cannot pay for nursing home expenses?
A: No. They can, however, put a lien on your home for any uncovered nursing home expenses that can be recovered upon your death or the death of a surviving spouse.

Q: How much do nursing home expenses currently cost in the Bay Area?
A: Typical nursing home expenses run $6,000 to $7,000 per month, but can also be much higher.

Q: Can I qualify for Medi-Cal by gifting assets to friends and family?
A: Generally no. Gifting assets can only be done far in advance or you will disqualify yourself from receiving Medi-Cal benefits. When you enter the nursing home, the state completes a detailed financial assessment and will look back 5 years to see if you have given away money or put it into an irrevocable trust. If you have, you must take the dollar amount you gave away and divide it by the average cost of a nursing home; that is the number of months you must pay for your nursing care before Medi-Cal benefits can begin.

Q: I have heard of the term "Medi-Cal Planning", what is it?
A: Medi-Cal planning is the legal transfer of assets, so they are not counted for Medi-Cal qualification purposes. Proper Medi-Cal planning can protect tens of thousands of dollars from Medi-Cal spend down, while allowing an individual to qualify for Medi-Cal benefits.

Q: If I have my assets in a revocable living trust are they counted for Medi-Cal qualification purposes?
A: Yes. Since you can change the terms of a living trust, it provides no benefit for Medi-Cal qualification, even if you have had the assets in trust for more than 5 years.

The above FAQs are for informational purposes only and should not be considered advice or counsel as to any particular individual or family's situation for estate or elder planning purposes.