What is Medi-Cal?
While Medicaid varies across states, Medi-Cal is free or low-cost healthcare designed to cover residents of California through managed health plans. It is not to be confused with Medicare. Medi-Cal is funded by federal and state taxes and serves low-income individuals, including seniors, children, pregnant women, and persons with disabilities. Most people who receive this coverage have no out of pocket expenses or co-pays, or premiums. Medi-Cal can cover the costs of in-home care and nursing homes indefinitely. Anyone can apply for Medical and if you qualify, you will continue to receive it as long as you meet the qualification requirements. However, the guidelines for qualifying for Medi-Cal can change frequently or without notice to you.
Medi-Cal offers twenty-one different healthcare plans including Anthem Blue Cross, Kaiser, and Molina. There are approximately 130,000 providers you can choose from and many recipients say it is easy to find one close by. You do not have to be completely impoverished to receive Medi-Cal. Unlike most states that use federally funded programs as a last resort, California’s health care system is designed to allow individuals and families to retain incomes, assets, and “safe harbor” allowances. There are some rules and restrictions that may be difficult to understand. This is why it is recommended that individuals who are applying for the program consult with a Medi-Cal elder law attorney in Sunnyvale to ensure that all is planned for to the fullest extent.
What are Assets and Income Limits With Medi-Cal?
Your assets deemed “countable” or “exempt” are considered heavily during the application process. “Countable” assets are any that have value toward the program. The list of exempt assets is short, so the countable assets are basically anything that does not belong on the exempt list. The limits for incomes and assets are strict. You cannot just give away any extras that you have, it will hurt you down the line. The Affordable Care Act simplified these limits. It also resulted in years of record lows of uncovered individuals. Property assets such as cars are not counted anymore, so people who were denied before are being encouraged to reapply. Medi-Cal does not try to recover costs from you until after your death if you are over the age of 55. At this point, costs will be recovered through your estate. The exception to this is individuals cared for by institutions or nursing homes. If you are under 55, you can receive Medi-Cal with cost recovery unless you are institutionalized.
Income limits are straight-forward and apply to residents of Sunnyvale or spouses of residents in nursing homes. There is an allowable income limit for those on Medi-Cal. They are calculated as a percentage of the federal poverty level guidelines. The limits are strict. If you go over the limit, or if your household size decreases, you may lose Medi-Cal. However, you can always apply for Covered California, another healthcare program for California residents. If a household member is in a nursing home and the income goes over the limit, the extra income will go to the nursing home to pay for the cost of living. Spouses may not have enough money to live on with their income alone and if this is the case, they are able to receive an MMMNA, or minimum monthly maintenance needs allowance. This is not always guaranteed, though.
Planning for Medi-Cal Long-Term
You should start to plan early for your or your loved one’s long-term care. This is the best option. You’ll have more flexibility and an easier application process if you do this. You will also be able to consider alternatives for paying for long-term care. There may also be complications due to maxed income or assets if you are not prepared. Medi-Cal will look back over thirty months to check and see if you have made any transfers of non-exempt property. California nursing homes and other long-term care agencies have been criticized for providing poor services and low quality of care that can cause dangerous situations for those who receive this care. Planning early may give you a jump start on selecting a home or agency so that you or your loved one can live as comfortably as possible.
Planning early can help you make sure that incomes and assets are being managed properly. You can avoid some real issues this way. You will have to wait through a period of ineligibility if you have mishandled these things. If you hire an experienced elder law attorney, they can help prepare you for avoiding errors on the application for Medi-Cal, cost recovery, what will happen to your spouse, and other complications that may come along down the road.
Hiring a Medi-Cal Planning Attorney
The whole process of applying for Medi-Cal and planning for the future is complex. There are many pitfalls you may encounter along the way and if you make a mistake, things will not go well for you. The rules and regulations can be difficult to navigate if you are not experienced. Hiring an experienced Medi-Cal attorney in Sunnyvale will make things easier. They can help you make sure you qualify for the care you need without causing a big disruption in your life. An experienced attorney knows how to turn regulations into advantages and can help you utilize them when the time is right.
Early planning may not always be an option. A Medi-Cal professional elder law attorney will identify options for you and help you to understand them. They will also help you to understand how the rules, restrictions, and regulations apply to you. You could put off the planning or go the do it yourself route, but that would only be to your disadvantage. In Sunnyvale, it is almost never too late to apply and qualify for Medi-Cal. Consider consulting an attorney. They will help you on your journey and you will be best prepared for what lies ahead. Whenever you are ready to talk to an expert, give us a call!
