Los Angeles elder law attorneys have in-depth knowledge of the machinations of the Medi-Cal program. This jointly administered federal/state government health insurance benefit is relevant because it will pay for long-term care.
Medicare will not pay for a stay in a nursing home or any other type of custodial care. This gap is considerable, because nursing facilities and in-home caregivers are very expensive. The state places an estimate on the average annual cost for nursing home care at about $120,000.
The average length of stay is 12 months, and this is just that, an average; some people spend years in nursing homes. There is also the possibility of a married couple being presented with two different sets of nursing home bills.
Over one third of seniors do in fact reside in nursing homes eventually, and 70 percent of all seniors will need some type of living assistance. When you digest these facts of life, you can see why this is a major elder law issue.
Medi-Cal Estate Recovery
We have some posts that look at various different aspects of the Medi-Cal eligibility parameters, and we share updated information on an ongoing basis. With this in mind, we will stick to the subject of Medi-Cal estate recovery here.
The limit on countable assets is just $2000, but there are some things that don’t count, including your home. People typically give assets to their loved ones before they enter nursing facilities so that they can qualify for Medi-Cal. They are essentially giving their family members their inheritances in advance.
This sounds simple enough, right? If and when you find out that you have to move into a nursing home, you can give these gifts and qualify for Medi-Cal a few days later.
That arrangement would be convenient, but it’s not that simple. There is a 30 month look back period in California. You have to wait at least 30 months after you give gifts before you can become eligible for Medi-Cal coverage.
Though this look back period is somewhat problematic, Californians actually get a break. In other states, the period is a full five years.
As we have stated, you can qualify for Medi-Cal if you are still in possession of your home. The program is required to seek reimbursement from your estate if you have assets in your name at the time of your passing.
You would not be able to qualify if you have significant assets other than your place of residence, so this would be the piece of property that would usually be in play. This is something to take very seriously when you are devising a nursing home asset protection plan.
Caregiver Child Exemption
There is one exception to the 30 month look back rule. If one of your adult children has been providing living assistance in your own home that has allowed you to stay out of a nursing home, you can take advantage of the Medi-Cal Caregiver Child Exemption.
You would be permitted to give the child your home under these circumstances, and Medi-Cal would not try to go after the property during estate recovery efforts. In order to take advantage of this exemption, the child must prove that they provided care for at least two years.
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