What is the Medi-Cal Program?

It’s a program in the state of California that helps pay for long-term care and other medical care needs. With Medi-Cal, in Covina and Temple City, you may only qualify for Medi-Cal long-term care benefits if you have limited assets, such as cash. For Medi-Cal planning and computation, you may exclude assets like a house, car, personal items like jewelry, and more. Medi-Cal benefits are useful if you need help with extra care in the home or in a skilled nursing facility, as Medicare often doesn’t cover the cost of long-term care.

Medi-Cal Law

Long-term care is one of the most important components of the Medi-Cal program in California. If you or a loved one cannot perform two activities of daily living—such as eating, bathing, grooming, transferring, toileting—then you may qualify to have Medi-Cal pay for your long-term care.

Qualifications for Medi-Cal

In order to qualify for Medi-Cal, you must meet the following eligibility requirements:

  1. Medical eligibility

    There must be a determination by a doctor that you cannot perform 2 out of 5 activities of daily living.

  2. Resource eligibility

  • Countable assets must be transferred outside of your name.
  • However, if you are married, there will be spousal allowances given to the spouse who is not trying to qualify for Medi-Cal.

Exclusions for Medi-Cal

Currently, these assets are not countable in California:

  • House
  • Personal effects
  • One automobile
  • Term Insurance
  • Whole Life Insurance with under $1500 cash value
  • Prepaid burial
  • Property used in trade or business
  • Special payments protected by law
  • Work-related plans (IRAs, 401Ks, etc.)
  • Certain Annuities

Income eligibility

There are different eligibility requirements for single persons and married couples.

Transfer eligibility

California has a 30-month look-back period, which means that gifts over a certain monetary amount made within 30 months may cause Medi-cal ineligibility.

As you can see, qualifying for Medi-Cal is typically not the simplest process.

In order to properly navigate these eligibility requirements, attorneys often draft a certain type of irrevocable trust called a Medi-Cal Asset Protection Trust. This Trust allows the client to protect their assets by moving those assets into the Trust, yet still qualifying for Medi-Cal.

Effective January 1, 2017, Medi-Cal can now only recover after the recipient passes away if there are assets that are subject to probate. This means that if a person moves his or her assets into a Trust, and receives Medi-Cal benefits, Medi-Cal will not be able to recover the person’s assets after death, allowing you to leave a legacy for your loved ones.

Due to the recent change in California, Medi-Cal planning has become a much more attractive option for so many of my clients. If you live in Covina, Temple City or surrounding areas, please contact Medi-Cal attorney Tony at (626) 858-9378 or request a free consultation below.

Further reading on Medi-Cal