Medi-Cal, California’s Medicaid program, provides healthcare coverage to thousands of low-income individuals and families. Although most people have a vague understanding of how Medi-Cal operates and what benefits are available to program beneficiaries, there are also a number of common myths about Medi-Cal that sometimes prevent otherwise eligible individuals from applying and benefitting from the program. The Medi-Cal attorneys at Schomer Law Group help you separate fact from myth.
Common Medi-Cal Beliefs – Fact or Myth?
1) I will lose my home if I apply for Medi-Cal.
FALSE. Probably the most common Medicaid myth. While it is true that Medi-Cal uses both income and “countable resource” limits when determining eligibility, your home is an exempt asset in most cases, meaning its value is not used when calculating the value of your countable resources.
2) I can only have $2,000 worth of assets or my application will be denied.
TRUE…for the most part. Medi-Cal does use asset limits, as mentioned in the previous question; however, not all of your estate assets are included when calculating your countable resources. If, however, the value of your countable resources does exceed $2,000, your application may be denied and you will need to “Spend-Down” your countable assets until they fall below the $2,000 limit at which point you may be eligible for Medi-Cal.
3) If I need help paying for nursing home expenses my spouse will be left with nothing.
FALSE. This was actually true at one point in time. Fortunately, Medicaid enacted the Spousal Impoverishment Rules to prevent a “community spouse” from suffering. Those rules allow a community spouse to retain his/her share of the marital assets as well as his/her own income. Your spouse may even be entitled to keep some of your income if his/her income is particularly low.
4) I can just transfer assets to my children if I ever need to qualify for Medi-Cal.
FALSE. This was once possible; however, Medicaid now uses a five-year “look-back” rule that requires a review of your finances for the five-year period prior to applying for benefits. Any asset transfers made for less than fair market value will potentially be disallowed and the value of the asset imputed back into your estate for the purpose of determining eligibility.
5) If I waited until the last minute, Medicaid planning strategies cannot help me.
FALSE. While it is always best to incorporate Medi-Cal planning strategies into your estate plan as early on as possible, there are some last-minute strategies that can help. For example, it may be possible to convert a non-exempt asset into an exempt asset without incurring any transfer penalties.
6) After my death, Medi-Cal can take my home and other assets if I received benefits while I was alive.
TRUE…for the most part. The Medicaid Estate Recovery Program (MERP) allows Medi-Cal to pursue a claim against the estate of a beneficiary in an attempt to recover money spent on the decedent while he/she was alive. Fortunately, recent changes to MERP in California significantly limit when a claim can be filed and what assets can be recovered.
7) If my income is above the Federal Poverty Level, Medi-Cal won’t help me with long-term care expenses.
FALSE. Medi-Cal has over 90 eligibility categories, each with its own eligibility guidelines. If you are 65 or older and your income is too high for the categories that require income below the FPL, you might still qualify under the Aged, Blind, and Disabled – Medically Needy Medi-Cal category. If you do qualify, you will have a “share of cost” amount, based on your income, that you must spend each month before Medi-Cal will start helping with your nursing home expenses.
Contact the Los Angeles Medi-Cal Attorneys at Schomer Law Group Today!
At Schomer Law Group, we understand that the Medi-Cal rules and procedures can be intimidating for a first-time applicant. If you are confused or you have additional questions, we are here to help. Contact the Los Angeles, California office today by calling (310) 337-7696 or (562) 346-3209 or by filling out our online contact form.
