One of the worst mistakes you can make when it comes to planning for the future is overlooking the potential need for Medi-Cal planning. What typically happens is that young, healthy clients assume that planning for long-term care in the future is unnecessary. While being healthy in your senior years is fantastic, that does not preclude you from needing health care assistance later on. Let our Orange County Medi-Cal planning attorneys help you plan.
Plan for the Unexpected
You may not have health issues right now, but can you actually predict how healthy you might be in 40 or 50 years? Regardless of that, you must consider the possibility of unexpected illnesses or injuries that could result in medical issues that require long-term care. According to some reports, more than 2/3 of the population over age 65 will require some type of long-term health care at some point in their lives For these reasons alone, Medi-Cal planning is a good idea for California residents.
It Isn’t Only the Terminally Ill Who Need Long-Term Care
A common misconception many clients have is that you must be really sick or terminally ill to require long-term health care. That is not always the case. Unexpected, serious injuries can also result in the need for long-term care simply to fully recover. In some situations, individuals are admitted to nursing homes or assisted living centers because of the need for help with daily activities like dressing and grooming. In fact, this could simply be the result of aging. There are so many different situations that can result in the need for long-term care so you need to be prepared.
Often Private Health Insurance is Not Enough to Cover the Costs
Many people underestimate the potential costs of long-term care, which can be rather expensive, even overwhelming for some. In California, the average yearly cost of long-term care in 2017 was more than $110,000. Many people believe they can afford those costs by simply relying on Medicare benefits and private health insurance. This is a mistake. In reality, Medicare and private insurance rarely cover all, if any, of the costs of long-term care.
How Does Medicare Coverage Work
Medi-Cal and Medicare are two very different health care benefits programs. Medicare is a health insurance program available for individuals who are age 65 and older, disabled, or dialysis patients. It is administered by the federal government. Unlike Medi-Cal, eligibility for Medicare is not based on income or need. Instead, Medicare recipients are required to pay a portion of their medical expenses through deductibles and small monthly premiums for non-hospital coverage. If you are still confused about how this works, our Orange County Medi-Cal planning attorneys explain.
Types of Available Medicare Coverage
Medicare is divided into two primary plans that provide different types of coverage. Medicare Part A is the insurance plan for health care services provided by hospitals, skilled nursing facilities, home health care, and hospice care. While Medicare Part B is similar to basic health insurance which provides coverage for doctor visits, outpatient hospital care, and other medical services.
How is Medicaid different from Medicare?
One of the key differences between Medicare and Medicaid is that Medicaid is an income-based or needs-based health care assistance program. Federal, state and local tax funds are used to assist eligible individuals in paying their medical expenses. Generally, Medicaid recipients are only required to pay a minimal co-payment for covered medical expenses, if they are required to pay anything at all. Medicaid will generally pay for certain in-home services, but only when a physician certifies that home care services are actually needed for specific medical reasons.
How Medicare is different from Medicaid?
Medicare is different from Medicaid, first because Medicare benefits are provided by private companies through contracts with Medicare. However, Medicaid is run by each state’s Medicaid agency. Because Medicare is a federal program, eligibility and benefits are the same all over the United States. Even though Medicaid is not uniform in every state, coverage is generally available for eligible adults with children who live below a certain income level, pregnant women, seniors and individuals with disabilities.
Why Medi-Cal planning is so important
The purpose of the benefits Medicaid provides is to help low-income California residents to pay for their medical services. Because Medicaid is a needs-based program, its recipients must have less than $2,000 in assets. The goal of Medi-Cal planning is to prevent the need to exhaust all of your resources in order to become or remain eligible for benefits.
Furthermore, if a Medicaid applicant gives away property just before submitting an application for Medicaid benefits that transfer of property could be seen as fraudulent. That would result in your benefits being delayed or denied altogether. However, if you engage in careful Medicaid planning, you can avoid the appearance of fraudulent transfers.
If you have questions regarding Medi-Cal or any other elder law needs, please contact the elder law attorneys at Schomer Law Group for a consultation, either online or by calling us at (310) 337-7696.
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