Medi-Cal Planning for Long Term Care:

The high cost of long-term care has made planning a critically important issue for most middle class seniors and their families. In fact, most seniors will likely require some form of long-term care. Sadly, many of them are unprepared for the significant financial burdens it places on their family’s hard-earned savings. Financial devastation becomes an unwelcome reality for a family facing ongoing care at a rate of $8,000 or more per month.

We work with individuals, and their caregivers, to guide them through the challenging financial and legal decisions which occur as they grow older and require ongoing care. While there are significant federal and state benefit programs which were designed to assist the elderly, far too many people fail to understand how these programs function and what is required for eligibility. We work closely with our clients to ensure they have an understanding of the many legal options to protect assets and qualify for benefits that will help pay for long-term care.

Long-term Care Insurance 

While some seniors are able to afford private care, the cost of long-term care can easily wipe out savings of all but the wealthiest families in a matter of years. Those who have planned ahead by purchasing long-term care insurance have a degree of certainty and peace of mind, knowing that they have a lesser need to rely on other sources in the future. Unfortunately, many can’t afford the high cost of long-term care insurance or worse, because of age or medical conditions, cannot qualify for long term care insurance. If you do have long-term care insurance, you should be aware of what your policy covers. Many policies have high deductibles or a waiting period before it will provide a period of care in a medical facility. In fact, many who have long-term care insurance still have to resort to Medi-Cal to pay for their care.

Medi-Cal Eligibility

The other option to pay for care is Medi-Cal. A joint federal-state program, Medi-Cal provides medical assistance to certain individuals, including those who are 65 or older, disabled or blind. MediCal (known as Medicaid outside the State of California) is the single largest payer of nursing home bills in America and serves as the option of last resort for people who have no other way to finance their long-term care. Although Medi-Cal eligibility rules vary from state to state, federal minimum standards and guidelines must be observed.

While Medi-Cal eligibility with respect to long-term care was not overly restrictive in the past, there has been a steady drift towards more complex and limiting rules, the latest being the Deficit Reduction Act of 2005 which went into effect in 2006. While California has not implemented all of its requirements, these changes have resulted in complex eligibility requirements for those in need of Medicaid benefits in other states. It’s no longer as easy as reviewing one’s bank statements. There are a myriad of regulations involving look-back periods, transfer penalties and waiting periods to plan around.

Pre-Medi-Cal Planning 

Far too often, seniors wait until they fall ill and require care to seek the assistance of an attorney. Unfortunately, in waiting for a crisis, seniors and their caregivers often encounter more hurdles for qualification and high levels of stress during an already difficult time. We assist clients with pre-Medi-Cal planning, developing a long-term plan which seeks to protect assets through traditional estate planning functions and asset protection tools such as irrevocable trusts while coordinating private insurance, veterans benefits and other resources which may be available to pay for future care, without draining all of the family’s assets.

Helping You Qualify for Medi-Cal 

Even if you haven’t taken time to plan for Medi-Cal eligibility, there are a number of tools at your disposal to obtain eligibility. We assist clients who are just starting the process and need to qualify immediately. In these situations, we work directly with seniors, geriatric care managers, caregivers, social workers, care facilities and healthcare providers to identify the best environment for your ongoing care. We work with you to complete the Medi-Cal application and when necessary, “spend down to qualify” in a meaningful way which won’t waste your hard earned assets but instead benefit your loved ones for years to come.

We can help you avoid the financial ruin associated with the high cost of long-term care. Contact us today to learn more about the issues surrounding Medi-Cal eligibility and to begin the planning and application process.