However, under ACA Obamacare Medi-Cal no longer has asset recovery for Health Insurance Premiums – Capitation. under MAGI Medi-Cal. Jump to definition of what “Health Care Means.” CA changed the law as CA had extra $$$ pre COVID and the new budget includes $30 million to limit Medi-Cal estate recovery only to that required by federal law. See actual code below. KQED News 6.16.2016 * 3.24.2015 * SB 33 * SB 833 * Simple Explanation CA HealthLine 12.23.2016 * DHCS.CA.Gov
Medi Cal can still take your home for nursing care! There are ways to plan for this and the new laws updated Nursing Home Recovery too. Read this entire page along with our pages on Long Term Care Insurance for information or details. See the button about setting a no charge or obligation consultation.
Here’s the Actual NEW CA Law
SB 833 §14009.5. Effective 1.1.2017
(a) It is the intent of the Legislature, with the amendments made to this section by the act that added subdivision (g), to do all of the following:
Federal and State laws require DHCS to seek recovery
from the estates of deceased Medi-Cal beneficiaries, or from any recipient of the decedent’s property by distribution or survival, for services and premiums paid on behalf of the decedent on or after age 55.
- California Code of Regulations (CCR) sections 50960-50966
- Welfare and Institutions Code (W&IC) section 14009.5
- Probate Code section 215
- Probate Code section 9202
- Probate Code section 19202
- United Stated Code (USC) section 1396
How to qualify for
Medi-Cal to pay your Nursing Home Costs
California Advocates for Nursing Home Reform (CANHR) –
- Medi-Cal vs. Medicare
- Medi-Cal Eligibility
- $2k for a Single
- How to complete the MC 262 Redetermination Form
- Share of Cost
- What Does Medi-Cal Cover?
- Nursing home care is covered if there is prior authorization from the physician/health care provider. Residents are admitted on a doctor’s order and their stay must be “medically necessary“. (Clinical UM Guidelines) Residents are allowed to keep $35 of their income as a personal needs allowance.
- Resource Limitations (Property/Assets)
- The Home
- Other Real Property/Business Property
- Spending Down/Gifting Assets
- Spousal Impoverishment Laws
- Graphic Chart
Medi-Cal Consulting Services
Medi Helper.com They can help you qualify – fee charged based on complexity of your case.
Strategic Planning for Nursing Home Benefits
What type of trusts can protect family assets?
The creator of a trust can retain the income and life use of assets contributed to an irrevocable living trust (ILT). Assets transferred to an ILT are subject to a 60-month look-back rule under Medicaid.
Yes, this is all VERY confusing and complicated.
California Medi Cal is 30 months…
So, it might be best to use an attorney to set up and check over your final plans and documents.
Because of the retained life interest under IRC section 2036, the trust property will receive a stepped-up income tax basis upon the death of the creator.
The 60-month look-back period applies to assets transferred to and from any type of trust. An individual with a revocable grantor trust should first transfer assets from this entity to her name before making gifts in order to have the shorter 36-month rule apply. With respect to trust disbursements of income or principal, any creditor ?steps in the shoes? of a beneficiary (i.e., to the extent that this individual is entitled to receive any benefits, so would the creditor). The Exhibit summarizes when income and principal from a trust can be considered as an available resource for Medicaid. This chart reflects that the look-back rules are not applicable to testamentary trusts, although a provision should be included that no benefits are payable to any beneficiary who otherwise would qualify for governmental benefits nysscpa.org/
gift in contemplation of death
n. (called a gift causa mortis by lawyers showing off their Latin), a gift of personal property (not real estate) by a person expecting to die soon due to ill health or age. Federal tax law will recognize this reason for a gift if the giver dies within three years of the gift. Treating the gift as made in contemplation of death has the benefit of including the gift in the value of the estate, rather than making the gift subject to a separate federal gift tax charged the giver. If the giver gets over an apparently mortal illness, the gift is treated like any other gift for tax purposes.
Medi-Cal FAQ’s – only 30 month look back in CA
What is the
CA Assisted Living Waiver?
Participants in the ALW have access to the following services:
- Assisted Living Services: The following is a list of some of the services that must be provided to ALW participants. These services may be provided in an RCFE, or by a licensed Home Health Agency to residents in public housing.
- Assisting in developing and updating an individualized care plan for each resident
- Personal care and assistance with activities of daily living
- Maintenance of the facility
- Providing intermittent skilled nursing care
- Meals and snacks
- Providing assistance with self-administration of medications
- Providing or coordinating transportation
- Providing recreational activities
- Providing social services
- Care Coordination: These services include identifying, organizing, coordinating and monitoring services needed by participants .
- Nursing Facility Transition Care Coordination: These services help transition participants from a nursing home to the community. CA Assisted Living Waiver
Resources & Links
DHCS.CA.Gov – CA Department of Health Care Services
Elder Options – Private Website – DHCS subcontractor that can help people in Sacramento Area
My 92 year old mother is on Medi-cal and Scan, but needs to go into assisted living with waiver application. They won’t accept Scan. They said she has to drop it. Does she automatically go on Medi–Medi and will her new doctor take it? The application takes 3-6 months for approval but I have to drop her from Scan insurance before I fax over the waiver form…
***I don’t have enough background to answer your question. I did learn though, my first day at my Father’s & Grand Fathers Insurance Agency, to NEVER cancel coverage till new coverage was confirmed!
Links & Resources
- California Advocates for Nursing Home Reform html
- Daily Kos
- CA Health Care Foundation
- Simple Explanation CA HealthLine 12.23.2016
- Insure Me Kevin.com –
- Check out Long Term Care Coverage
- DHCS.CA.Gov Explanation
- Insurance and Annuity Disclosure form – might trigger change in Medi Cal eligibility?
- Lentillem Law Site
- Drobny law.com
- Elder law- Attorneys.com
- Attorney - Staker.com/
- Medicaid Planning.org - Attorney Training
- Legal Match.com
- Attorney - Staker.com/
- Medicaid Planning.org - Attorney Training
We don't necessarily know these attorneys, they just appear to have very informative websites
Resources, Child Pages & Sibling Pages
Medi Cal and Medi Cal Technical Info.
LIS Low Income Subsidy Part D Rx Medicare
- §1035 Exchange of Annuities or Life Insurance for Long Term Care Planning
- 7 Activities of Daily Living ADL
- Employer Groups – Long Term Care
- Medi Cal – Estate Recovery – Strategic Planning
- True Freedom – Home Health Care ONLY Coverage