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Ones And Your Legacy

Help With Elder Law And Medi-Cal

Q: How much does nursing home care usually cost?

Long-term care in California can be expensive. On average, nursing home residents may pay between $4,500 and $8,000 per month for standard care, with significantly higher costs for advanced medical needs. Because of these expenses, qualifying for Medi-Cal assistance can help reduce out-of-pocket costs.

Q: Will receiving Medi-Cal benefits result in a claim against my estate?

Medi-Cal may seek to recover certain assets, including real estate and personal property, after a beneficiary's death. Recovery is typically limited to the amount of benefits provided. However, proper Medi-Cal planning strategies, such as the use of trusts or other legal tools, may help protect assets from recovery.

Q: Are past nursing home expenses reimbursable by Medi-Cal?

Medi-Cal may cover eligible expenses for up to three months prior to the application date if the applicant met eligibility requirements during that period. In some cases, additional legal options may be available to pursue retroactive benefits.

Q: What happens if I make a large gift right before applying for Medi-Cal?

Transferring assets before applying for Medi-Cal may trigger a period of ineligibility, often referred to as a look-back period. The length of ineligibility depends on the value of the assets transferred. It is important to seek legal guidance before making significant financial gifts.

Q: What about transferring assets to my spouse?

In some situations, transferring assets to a spouse may be allowed under Medi-Cal rules. However, there are limits on the amount of non-exempt assets a spouse can retain. Proper planning is necessary to ensure compliance and protect eligibility.

Q: Will any money I earn go to my spouse?

Income earned by a spouse in a nursing home may be allocated toward the cost of care or may be shared with the community spouse, depending on Medi-Cal rules. Income and asset changes can affect eligibility, so careful planning is important.

Q: When is the best time to start planning?

The best time to begin Medi-Cal planning is as early as possible. Early planning provides more options to protect assets and secure eligibility, although assistance may still be available in urgent or last-minute situations.

Most seniors will require some form of nursing home or long-term care during their elderly years. The attorney at the Law Offices of Gerald L. Kane understands the multitude of emotions that come with preparing for this reality:

Parents who are afraid of being lost in the system or becoming a burden for their children
Children who only want the best for their parents, but do not know how to find such care or how such care can be afforded
Seniors afraid that the cost of long-term care will leave their surviving spouses completely impoverished and without much-needed assets
Families that are concerned about preserving the legacy of a loved one and are fearful of losing such legacies to nursing home costs

Gerald L. Kane is dedicated to serving as your personal family lawyer as he serves your family’s legal needs through all generations of life. Contact him to schedule an appointment with a skilled Los Angeles elder law attorney: 818-905-6088.

He discusses long-term care options and asset protection strategies with clients, as well as Medicaid/Medi-Cal planning strategies that enable clients to become eligible for government-funded services to cover nursing home and long-term care costs. Read his FAQs about Medi-Cal in particular.

Beware: The Rules Are About To Change, So Plan Now

It’s important to plan as early as possible to have the most flexibility and options. The rules regarding Medi-Cal are about to change, and the 30-month “look-back” period will go away. This means you want to plan now, before the rules change.

Right now, it’s still possible for many people to protect their homes and assets through the creation of irrevocable trusts, veterans trusts, Medi-Cal trusts and other estate planning tools. The right trust can help you avoid becoming impoverished by the costs of nursing home care.

Helping Families Afford Long-Term Care

Very few families can afford more than a few months of nursing home care without depleting their entire estate. While some people purchase long-term care insurance to alleviate the cost of such care, most people will need Medicaid to cover the expense of nursing home, assisted living and other long-term care.

Medi-Cal, California’s Medicaid program, provides coverage for nursing home care and other medically necessary health care services. However, because Medi-Cal is a government-funded medical assistance program, eligibility is determined by assets and income. Medi-Cal is designed to provide for long-term care in a skilled nursing facility.

Although various waiver programs are available, they are limited and come with long waiting lists. Therefore, it may be essential to review other funding options and to plan as early as possible, if you wish to receive in-home care or assisted care. In some cases, veterans qualify for special pensions.

Proactive Life Planning

Proactive Medi-Cal/Medicaid planning is essential to becoming eligible for benefits when they are needed. Mr. Kane helps clients navigate the complex Medi-Cal rules and eligibility requirements, keeping in mind federal look-back periods, asset-transfer penalties, and waiting periods that ultimately affect if and when an individual may become eligible for Medi-Cal benefits.

Frequently Asked Questions

A vast majority of U.S. citizens will need long-term nursing home care or other long-term medical assistance at some point in their lives. Most will have difficulty covering the cost of such care without some form of public assistance such as that available through Medi-Cal.

Mr. Kane is sensitive to the needs of families that are preparing to ensure eligibility for Medi-Cal and other similar programs. Many are concerned about losing their family homes and other property to the state as a consequence of receiving public aid.

How Much Does Nursing Home Care Usually Cost?

Long-term care in California is quite expensive. On average, nursing home residents pay between $4,500 and $8,000 per month. This is for standard care only. If you require significant medical assistance, you may end up paying more than $25,000 each month. This is why qualifying for Medi-Cal assistance is so critical. With Medi-Cal, you will only have to pay a fraction of the total cost.

Will Receiving Medi-Cal Benefits Result In A Claim Against My Estate?

Medi-Cal does attempt to recover assets, including houses, vehicles and other personal property owned at the time of the beneficiary’s death. Medi-Cal has the right to recover up to the total amount of benefits received during the beneficiary’s life. Fortunately, strategic Medi-Cal planning can prevent the loss of your home and other property. Typically, the best way to avoid an estate claim is to leave no assets in the estate. This can often be done through certain trusts, irrevocable life estates, occupancy contracts and other methods.

Are Past Nursing Home Expenses Reimbursable By Medi-Cal?

Medi-Cal benefits are reimbursed only for the three months immediately preceding your approved benefits application, provided the beneficiary was eligible for benefits during those three months. Mr. Kane can also explain the possibility of filing a “3100 court petition” or pursuing an “administrative fair hearing” to increase the limit of eligibility and obtain retroactive payments.

Can I Keep My Assets And Still Be Eligible?

It depends. You may keep your home, automobile and various other exempt assets that qualify. Mr. Kane can help you determine what assets you can keep to still be eligible for benefits.

What Happens If I Make A Large Gift Right Before Applying For Medi-Cal?

This could potentially backfire on you. If you attempt to reduce your assets by giving a significant amount away, it may disqualify you for Medi-Cal benefits for a certain length of time (known as the “look back” period). Typically, the more you give away, the longer you will remain ineligible to your nursing home care paid for by Medi-Cal. However, under certain circumstances, gifting can be very advantageous. Before making any gifts, consult Mr. Kane.

What About Transferring Assets To My Spouse?

In some cases, it may be beneficial for you to legally transfer your assets to your spouse if you are entering a nursing home. Mr. Kane has filed many petitions with the court to transfer such assets between spouses. However, you need to be aware that your spouse’s non-exempt assets need to fall below a certain level. This is the tricky part, and Mr. Kane encourages you to set up a consultation with him to learn more.

Will Any Money I Earn Go To My Spouse?

It depends. If a spouse in a nursing home earns any income, it may go to his or her well spouse, or it may go toward the “share of cost” that he or she is expected to pay toward nursing home care. Likewise, an inheritance or other money that the well spouse receives may make the ill spouse ineligible for Medi-Cal coverage unless handled carefully. Let Mr. Kane explain the minimum monthly maintenance needs allowance (MMMNA), 3100 petitions and other issues that can make a significant difference.

When Is The Best Time To Start Planning?

Ideally, you should start planning for Medi-Cal as early as possible. The earlier you start exploring your options, the more likely it is that you will be able to accomplish your goals while preserving your assets. However, it’s never too late to consult a lawyer and learn about Medi-Cal benefits. Mr. Kane can assist you in creating a Medi-Cal plan in a short-notice situation or emergency. In fact, many of his clients fall into this category.

Contact Mr. Kane To Learn More

Please contact the Law Offices of Gerald L. Kane in Encino to schedule a no-obligation initial consultation with a San Fernando Valley Medicaid planning attorney.

Mr. Kane is available during regular office hours and on weeknights and weekends by appointment. He looks forward to meeting and working with you to find legal solutions that meet your needs. Call 818-905-6088.