Medi Cal Rules Are Changing

Temecula and Murrieta Medi-Cal Attorneys advise that you plan while you can still make sound decisions.

Many senior citizens need the services of a nursing home or at-home care at some point in their life. You might assume that government assistance or your health insurance will step in and cover the cost if you cannot afford these services. 

The truth is neither health insurance nor Medicare covers long-term care. Because obtaining long-term care insurance can be very expensive, Medi-Cal could become your only option.

Medi-Cal coverage is not a given, however. If you have assets or recently transferred assets, Medi-Cal may determine you do not qualify for coverage until a certain amount of time has passed. If this happens, you and your family can face significant medical bills. If you cannot pay, nursing homes may take you to court to get reimbursed. 

It is important, before applying for Medi-Cal, to get a better understanding of the timelines that have been established in California – known as lookback periods – that can affect your eligibility by talking to one of our Temecula Medi-Cal Attorneys.

Once you have an understanding of the timelines to be aware of, you can engage in proper Medi-Cal or asset protection planning of these timeframes. A good age to begin planning is around age 65, although everyone’s situation is different.

All states run individual programs, and every state has different rules regarding eligibility. These programs were designed as a payor of last resort — in other words, to qualify, you must meet strict requirements. There are two primary types of Medi-Cal benefits: non-long-term care (non-LTC), such as, home care, and long-term care (LTC), such as skilled nursing home care.

Lookback Periods

You must apply to your local Medi-Cal office to qualify for these benefits. As part of this process, the state will look at any money or property you may have transferred within a certain lookback period. 

As of January 2022 California has new rules. For non- LTC the look-back period is 90 days and for LTC, skilled nursing care, the period that used to be 30 months is now 60 months.

These lookback periods can have serious consequences. If you have not engaged in appropriate asset protection planning, you may not be able to qualify for home care or nursing home care for many months. The result is that many elderly individuals must then spend down their savings and liquidate their assets to pay privately for their home care before Medi-Cal starts covering anything. If a person no longer has resources and is subject to a disqualification penalty period, family members may have to step in and bear these costs on their own.

So, what can you do? The answer is to start planning as soon as is practical.

Options to Explore

Speaking with a Copenbarger & Copenbarger Elder Law attorney can help you and your loved ones explore options available to avoid you or them being personally responsible for the costs of your care.

  • Medi-Cal Asset Protection Trust — One common approach is placing assets in a Medi-Cal Asset Protection Trust. You may be able to use this to shelter various assets such as stock accounts, savings, a home with unprotected equity, and much more.
  • Other options — Other options you may explore are using a technique called “stacked gifting” using a “half of loaf” option or allocating income to a spouse whose income does not meet the minimum monthly needs allowance. 
  • Asset Limit — Before July of 2022, the number of assets allowable for a person applying for long-term nursing home care was $2,000. California as of July 2022, has increased that amount to $130,000, and if there is another family member living in the same household that amount is increased by $65,000.  Rules are changing and the best advice is to work with a law firm that can help you and can provide you with a comprehensive Medi-Cal eligibility analysis.

Finally, we can help you understand if certain transfers are permissible under Medi-Cal rules without triggering a penalty period.

Without proper planning, individuals with assets and income exceeding California state-set thresholds would have to spend this income and their assets on their care or exempt items before they can receive Medi-Cal benefits. 

If you are interested in learning more about the options available to avoid spending your hard earned assets, speak to our Temecula and Murrieta elder law or estate planning attorneys. To schedule an appointment at our Temecula office or one of our other offices located throughout the state of California, contact us at  (800) 244-8814.

If you have any further questions about asset protection planning and strategies to shield your wealth, or if you’d like to have your current asset protection plan reviewed to make sure it still meets your needs, please contact us at our California asset protection office at 800-244-8814 to set up a consultation.

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