Can The Medi-Cal Program Help Us?

Question from Ava C:

Just as we were beginning to enjoy retirement, my husband, Boyd, suffered a serious stroke. His doctors tell me he will require skilled nursing home care for many years. Must all our life's savings be spent for this care? Can the Medi-Cal program help us?

Lisa's Reply:

While Medi-Cal planning will not reverse your husband's illness, it may relieve some of the financial pressure on you and allow better care for you and your husband.

Unfortunately, the Medi-Cal rules are complicated but there are opportunities for your husband to obtain Medi-Cal benefits while still protecting your savings and financial security.

Neither Medicare nor ordinary health care insurance pays for most of the costs of long-term nursing home care. Medicare only pays for up to 100 days of medically necessary rehabilitative care, with a hefty co-payment you must pay after the first 30 days. Only insurance specifically designed to cover long-term care will pay for the custodial nursing home care your husband will need. Your husband may not be able to obtain such a policy after his stroke.

Under Medi-Cal eligibility rules, the at-home spouse is allowed to keep a minimum monthly income of at least $3,023.00¹ consisting of your monthly Social Security payment(s), a pension, IRA distributions and your share of the income from your savings and investments. In addition to the family residence, a married couple could also keep $120,900.00 in liquid savings and investments. In addition, the at-home spouse can automatically keep a car, jewelry, burial plots and all personal household goods and effects.

Most people do not know that a judge can make an order actually increasing the at-home spouses' monthly income and resource allowance to encompass a much larger amount than I automatically allowed. For example, I handled a heartbreaking situation in which a relatively young wife and mother was struck down with ALS, also known as Lou Gehrig's Disease. The Court allowed the at-home spouse to keep all of the family's assets, including an investment rental property and almost half a million dollars in cash and investments, once it was impossible to keep the wife safely at home. These are not easy requests to make to a court, but it is perfectly legal and authorized by the federal government.

Ava, with today's low interest, on CD's and other safe investments, the probate court may allow you to preserve hundreds of thousands of dollars of yours and still allow your husband to receive Medi-Cal benefits to pay for 100% of his nursing home costs.

¹These rates are for the 2017 calendar year. Each January 1 st, the Department of Health Services publishes new rates that increased based on cost of living adjustments.