Medi-Cal Long Term Care Basic Eligibility

Hi there. Bridget Mackay with the law offices of Bridget Mackay. I am an estate planning attorney working in Petaluma, California.

Today I want to talk a little bit about Medi-Cal basic eligibility, and I’m not talking about the Medi-Cal that young families receive for food and Medi-Cal. I’m talking about long-term care Medi-Cal that typically older adults apply for to pay for their care in skilled nursing facilities. Currently, 1.5 million Americans live in a skilled nursing facility. 70% of them rely on Medi-Cal or Medicaid to pay that bill. Here in Sonoma County, the monthly cost in a skilled nursing facility is $8,500 a month on average. So the cost can really take a toll on a family’s assets. If you are eligible for Medi-Cal, this cost may be significantly reduced.

What are the basic requirements to qualify for Medi-Cal?

  • Number one, you need to be 65 years or older, or disabled.
  • Number two, you may only have $2000 in assets if you’re single, or if you’re a married couple and one spouse is going into a skilled nursing facility, you can have $119,000 and $220 in assets.
  • Number three, you already are in a skilled nursing facility, or you need care in a skilled nursing facility. And if you need care in a skilled nursing facility, you need your doctor to sign off on that.

These seem like basic regulations or eligibility rules, just those three basic things, but in actuality, Medi-Cal and applying for Medi-Cal for long-term care is a very complicated and regulatory governed procedure. So you do not want to undertake applying for Medi-Cal on your own. Even if you think you immediately qualify.

In other words, if your assets qualify, which is where people often feel they don’t. But Medi-Cal eligibility is very complex, and it’s a web of federal and state regulations. It’s worth it to consult an attorney who practices in this area so that you don’t lose everything. Hope this has been helpful. Thank you.

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