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Home » Elder Law » Will Medi-Cal Pay for In-Home Care?

Will Medi-Cal Pay for In-Home Care?

September 24, 2019Elder Law

in-home care Medi-calBefore we address the subject at hand, we must provide some necessary background information. When you are planning ahead for your retirement years, you will invariably envision the good times that lie ahead. Without question, if you make the right choices along the way with regard to saving, you will have the financial underpinning that you need to enjoy your golden years to the fullest.

This is something that is fun to think about, and it should be, because people work hard all their lives to be able to enjoy some well-earned free time. However, as elder law attorneys, we are charged with the responsibility of sharing some facts that are not as pleasant to contemplate.

After the active retirement years, the twilight period will inevitably follow. The majority of senior citizens will eventually need living assistance of some kind. This is a reality that you should accept so you can be ready to make the appropriate plans when it becomes necessary.

It is important to understand the fact that Medicare will not pay for living assistance that is considered to be custodial care with no convalescent component. This is true when it comes to full-time residence in a nursing home or assisted living facility, and it also applies to in-home care.

The gap in the coverage is very significant when you look into the facts to find out how much you would have to pay if it is up to you to come up with the money. Genworth Financial is a company that offers financial products that are designed to meet some of the needs of senior citizens. They conduct ongoing research looking into the current state of long-term care costs around the country.

According to their survey, in the Los Angeles area where we practice law, the median annual charge for a year in a semiprivate room in a nursing home was $91,250 in 2018. For a private room, the figure was $109,500. The median annual charge for a one-bedroom unit in an assisted living facility was $54,000.

You may be surprised to hear that in-home assistance can actually be slightly more expensive than full-time residence in an assisted living community. Last year, the median cost for 12 months of in-home care was right around $57,000.

Clearly, any way you slice it, we are talking about a good bit of money, and a married couple may eventually absorb two rounds of long-term care costs.

Home and Community-Based Services Waiver

Medi-Cal is a need-based government health insurance program that does pay for living assistance if you can gain eligibility. It will cover a stay in a nursing facility, and a different program under the Medi-Cal umbrella called an Assisted Living Waiver will pick up the tab for in-home care.

It can be very disconcerting to be uprooted from your home late in your life, so in-home care can be an appealing option if you can gain eligibility for this program. However, since it is intended for people with limited financial resources, there are income and asset limits that must be taken into account.

Our Firm Can Help!

Clearly, gaining eligibility for this program is not a simple matter if you have some resources in your own name. That’s the bad news, but the good news is that we are perfectly positioned to gain an understanding of your situation and help you take the right steps to gain eligibility if it is at all possible.

We know that it can be disconcerting to discuss personal, family, and financial matters with an attorney that you have just met. You can rest assured that we got into this area of the law because we empathize with people that are in this position, and it shows when you interact with anyone on our team.

If you are ready to have a meaningful discussion with an elder law attorney, you can schedule an appointment if you give us a call at 310-337-7696. There is also a contact form on this website that you can use if you would prefer to reach out electronically.

 

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Scott Schomer, Estate Planning Attorney
Scott Schomer, Estate Planning Attorney
A graduate of Boston University School of Law, Scott P. Schomer is a frequent lecturer on estate planning and elder law issues, having discussed these important issues on local and national television. A seasoned courtroom advocate, Scott has obtained combined judgments and verdicts in excess of twenty-five million dollars for his clients. Scott has served as a member of the Los Angeles Superior Court Probate Volunteer Panel (PVP Attorney), Probate Settlement Panel and a Judge Pro Tempore. Scott's expertise has been recognized by his peers with such accolades as a life-time membership in the Multi-Million Dollar Advocates Forum, the Five Star Wealth Manager designation, and repeated nominations as California Super Lawyer.
Scott Schomer, Estate Planning Attorney
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