If you are over the age of 65 and still relatively healthy, that is something to be happy about. But that doesn’t mean you don’t need to consider Medi-Cal planning. Why? Because you never know if you might need long-term care at some point in your life. The worst mistake you could make is overlooking the need for Orange County Medi-Cal planning. Unexpected illness or injury can leave anyone with medical issues that require long-term care. It is reported that more than 2/3 of the population over age 65 will require some type of long-term health care at some point. For that reason alone, Medi-Cal planning is a good idea for everyone.
Lack of a Current Illness Doesn’t Mean You Will Never Need Long-Term Care
A common misconception is that you have to be sick to before you need to plan for long-term care. That is not always the case because serious injuries can also result in the need for long-term care in order to fully recover. In some cases, people are admitted to nursing homes or assisted living centers because of the need for help with daily activities like dressing and grooming. This could simply be the result of aging. There are many ways that a person’s situation could change making the need for long-term care an unexpected reality.
Orange County Medi-Cal Planning is Useful Because Insurance is Typically Insufficient
Many people underestimate the potential costs of long-term care, which can be rather expensive, even overwhelming for some. In California, the average annual cost of long-term care is more than $94,000. Many people believe they can afford those costs by simply relying on Medicare benefits and private health insurance. This is a mistake. The truth is, Medicare and private insurance rarely cover the cost of long-term care.
How Does Medicare Work?
Medicaid 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 Medicaid, 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.
How is Medicare Different from California’s Medi-Cal Program?
One of the key differences between Medicare and Medi-Cal is that Medi-Cal 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, Medi-Cal recipients are only required to pay a minimal co-payment for covered medical expenses, if they are required to pay anything at all. Medi-Cal 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.
Medicare is also different from Medi-Cal because Medicare benefits are provided by private companies through contracts with Medicare. However, Medi-Cal is run by California’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 is Orange County Medi-Cal Planning so Important?
The purpose of the benefits Medi-Cal 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 Medi-Cal 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 Orange County Medi-Cal planning, you can avoid the appearance of fraudulent transfers.
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Scott Schomer, Estate Planning Attorney
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