Medi-Cal Crisis Lawyers

Medi-Cal Crisis Assistance in California

A Full-Service Attorney for Medi-Cal Planning

Even the families of individuals who carefully planned for their later years and the uncertainty that this time in their lives can bring can be shocked and surprised when a calamity suddenly takes their loved one's health or well-being. When this happens, the loved ones who must make decisions can panic and feel lost.

This can prove to be detrimental to their loved one or family member: a delay in obtaining the appropriate medical care or treatment can harm the prognosis of the individual. Or failing to apply for and obtain benefits can result in a depreciation of assets the individual had accumulated over his or her lifetime.

 

Medi-Cal (Medicaid) Eligibility

Medicaid, known as Medi-Cal in California, is the one government program that pays for long-term care in a nursing home. For those who wish to live at home or in assisted living, sometimes Medi-cal will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. 

Unlike Medicare, which is available to almost everyone who reaches the age of 65, Medi-Cal has strict eligibility standards based on your medical needs, financial resources and income.

Due to the low income and asset level requirements, many people don't think they will qualify for Medi-Cal so they never attempt to apply for benefits. This is a big mistake! At Santa Barbara Estate Planning & Elder, we use the rules to implement proper, effective and legal strategies to obtain Medi-Cal benefits for our families, while simultaneously protecting as much of their income and assets as possible. Contrary to popular belief, you do not have to “spend down” your life savings in order to obtain the benefits you've earned.

There are several Medi-Cal programs in California (Assisted Living Waiver Program (AWL), In-Home Support Services (IHSS), and Skilled Nursing Home Care) available to qualifying seniors. Each program has different requirements and benefits, which can make the application process confusing. Further complicating matters is the eligibility criteria which differs between single individuals and married couples.

 

2021 California Medicaid Eligibility

There are several different Medicaid programs in California available to seniors who qualify. They have different requirements and benefits, which can make it confusing. Further complicating matters is the eligibility criteria if you are single or married.

Monthly Maintenance Needs Allowance: $3,260

  • Applies when: One spouse lives in the nursing home and the other spouse (the “Community Spouse”) lives outside of the nursing home.
  • Definition: Maximum income each month that the Community Spouse may keep. If both spouses' combined monthly income is lower than the minimum amount, then the Community Spouse keeps all the income (and it may be possible to expand the resource allowance so the Community Spouse can keep more than $130,380).

Maximum Community Spouse Resource Allowance: $130,380

  • Applies when: One spouse lives in the nursing home and the other spouse (the “Community Spouse”) lives outside of the nursing home.
  • Definition: Maximum amount of assets that the Community Spouse may keep in most situations. The Community Spouse may keep $130,380. This amount may be be increased by court petition.

Monthly Personal Needs Allowance: $60

  • Applies when: A person is receiving Medicaid benefits while living in the nursing home.
  • Definition: Monthly dollar amount that a Medicaid recipient may keep for personal items which Medicaid does not cover (e.g. haircuts). Thirty dollars ($30) more may be available for veterans.

Divestment Penalty Divisor: $10,184

  • Applies when: A potential Medicaid recipient transfers assets.
  • Definition: This figure, based on the statewide average of monthly nursing home costs, is used to determine the length of time an individual or couple is ineligible for Medicaid benefits because of transfers they have made.

Every divestment, no matter how small, triggers a penalty and denial of benefits.


Resource Allowance for an Individual: $2,000

  • Applies when: A single person living in the nursing home applies for Medicaid benefits.
  • Definition: Maximum amount of assets a single person may own and still qualify for Medicaid benefits.

Resource Allowance for a Couple: $3,000

  • Applies only when BOTH spouses reside in a nursing home.
  • Definition: Maximum amount of assets a couple may own and still qualify for Medi-Cal benefits. If one spouse has received Medi-Cal benefits for more than one (1) year and then the other spouse moves to a nursing home and applies for benefits, a different rule may apply.

IMPORTANT: You do not have to spend down your life savings to qualify for Medi-Cal. There are legal and ethical strategies that an expert Elder Law attorney can utilize, to get you the benefits you've earned.

Contact Us Today

Santa Barbara Estate Planning & Elder Law is committed to answering your questions about Elder Law, Medi-Cal Planning, VA Benefits, Special Needs Planning, Estate Planning, Conservatorships, Probate/Trust Administration in California.

We'll gladly discuss your case with you at your convenience. Contact us today to schedule an appointment.

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