FAQs

The home is exempt (not counted) for purposes of applying for Medi-Cal. However, it is considered a deferred asset, which means it can be counted for reimbursement to the Medi-Cal after a recipient is deceased or leaves the nursing home. Therefore, you should consider pre-planning in order to protect your home from a possible future Medi-Cal recovery lien. This is a very important step that many people do not understand.

Our staff helps many families with immediate needs as well as those in the pre-planning stages to qualify for Medi-Cal Benefits. We assist families who are concerned about protecting their assets and who want to take steps to ensure that they do not inadvertently create a period of ineligibility. By utilizing our pre-planning program our clients may obtain Medi-Cal benefits when needed with minimum spend down exposure. In addition, we counsel and assist those who are merely inquiring and want to learn about their pre-planning options. (Every step we take follows Medi-Cal guidelines and is accepted by Medi-Cal)

A. Briefly, Medicare is a Federally funded and administered program that provides health insurance for older Americans and those who are disabled and who have contributed to the Social Security system for a requisite number of years. Since Medicare is a Federal program, eligibility guidelines and services are the same throughout the U.S. Medicare will only pay for up to the first 100 days of a Nursing Home stay, and in most cases it pays approximately 20-40 days. More details regarding your specific situation will be explained during our educational consultation, described in item (3) above.

B. Medi-Cal/Medicaid is most often defined as a health insurance program financed and jointly funded by the Federal and State governments. Medi-Cal/Medicaid has two programs; one for low-income people of all ages and one for skilled nursing home care. Even though you may have significant assets, this program is an entitlement that belongs to you, just like Social Security, that you earned through paying your taxes while working. It is defined under Title Nineteen (19) of The Social Security Act. Many people with significant assets qualify for the Medi-Cal program each year by utilizing our pre-planning approach (approved by Medi-Cal)

Share of cost is a monthly deductible that is payable by you to the nursing home, and other healthcare providers. It is used to reduce the total cost that Medi-Cal/Medicaid pays for healthcare. Under certain circumstances, we can help you take steps to reduce or in many cases eliminate your share of cost. It is generally paid from your “INCOME” not your “ASSETS” while you are receiving monthly care in the nursing home.

Medi-Cal benefits cover nursing home costs, some medical equipment, necessary therapy and most prescriptions. The benefits generally do not cover assisted living and/or residential care.

The greatest enemy of Long-Term Care Estate planning is procrastination. You should ask yourself: “If I do not plan, who will it hurt the most?” “How much will it cost if I don’t plan?” How do I protect my spouse at home if our assets are being depleted on long term care costs”? And, “If I don’t pre-plan what will happen to our estate and our financial security?” What if I come home from nursing home care & my assets are depleted?”

Long-term care refers to various medical, personal and social services required by individuals who can no longer care for themselves in day-to-day life functions, sometimes referred to as “activities of daily living.” While most people attribute nursing home care to old age, or dementia, in reality it covers many medical conditions caused by accidents, stroke and many other illnesses, which may result in limited mobility reducing your ability to perform activities of daily living.