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Medi-cal Spend Down: How to Become Eligible for Medi-cal in California

If your income is low and you are “medically needy,” you may be eligible for healthcare assistance through the Medi-Cal program in your state. Learn more about medi-cal spend down in California in this presentation.

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Medi-cal Spend Down: How to Become Eligible for Medi-cal in California

  1. 1. MEDI-CAL SPEND DOWN How to Become Eligible for Medi-Cal in California
  2. 2. MEDI-CAL SPEND DOWN
  3. 3. If your income is low and you are “medically needy, ” you may be eligible for healthcare assistance through the Medi-Cal program in your state 3;. SCIIOMIZR L/ ’GROUP _ probate. trusts. cslalcs , ' _l, l l __/ -é‘-ij
  4. 4. To qualify, your financial resources must not exceed the maximum resource amount set in your state 3;. SCIIOMIZR LAWGROUP _ probate. trusts. cslalcs A ' , l_l l ___, -1.(_r7x—
  5. 5. However, if your income does exceed that amount, you may still be eligible if you follow Medi—Ca1’s spend down rules. So, how does the Medi-Cal spend down process work? 3;. SCIIOMIZR L/ ’GROUP _ probate. trusts. cslalcs , ' _lgl l __/ -é‘-ij
  6. 6. UNDERSTANDING THE MEDI-CAL PROGRAM
  7. 7. The purpose of Medi-Cal is to provide medical care assistance to low income individuals and families. Medi—Cal is funded and operated on both the state and federal levels 3;. SCIIOMIZR L/ ’GROUP _ probate. trusts. cslalcs , ' _lgl l aj
  8. 8. Understand that Medi-Cal is not the same as Medicare, which is a federal health insurance program for the disabled and individuals age 65 and older 3;. SCIIOMIZR L/ ’GROUP _ probate. trusts. cslalcs , ' _lgl l __/ -é‘-ij
  9. 9. How ASSISTANCE IS PROVIDED?
  10. 10. With Medi—Ca1, the physicians, hospitals and other medical care providers, who are enrolled in the Medi-Cal program, are paid on your behalf 3;. ScIioMi: R L/ ’GROUP _ pr0bzilc. lrus1s. cslalcs A ' , l_l l ___, -1.(r_7x—
  11. 11. Medi-Cal is not a reimbursement program. Depending on your situation, some adults receiving Medi-Cal are Still required to pay a portion of their medical expenses 3;. ScIioMi: R L/ ’GROUP _ probate. trusts. cslalcs A ' , l_l l ___, -1.(_r7x—
  12. 12. CAN I GIVE AWAY MY ASSETS?
  13. 13. A Very common misconception is that you can simply give away your assets in order to become eligible for Medi-Cal
  14. 14. Medi-Cal agencies take issue with people giving away their assets in anticipation of applying for Medi- Cal. y? Because those assets could have been used to pay for their own medical care 3;. ScIioMi: R L/ ’GROUP _ pr0bzilc. lrus1s. cslalcs A ' , l_l l ___, -1.(r_7x—
  15. 15. TIMING IS EVERYTHING
  16. 16. That does not mean you cannot give anything away. It all depends on the timing 3;. ScIioMi: R L/ ’GROUP _ pr0bzilc. lrus1s. cslalcs A ' , l_l I ___, -1.(r_7x—
  17. 17. If you transfer your assets within five years of applying for Medi-Cal benefits, your Medi-Cal benefits will likely be withheld 3;. ScIioMi: R L/ ’GROUP ‘ . '1' _ ' pr0bzilc. lrus1s. cslalcs A ' , l_I I
  18. 18. This period of ineligibility is known as the “penalty period, ” and the extent of that period depends on the Value of the assets transferred 3;. ScIioMi: R L/ ’GROUP _ pr0bzilc. lrus1s. cslalcs A I _l, I I aj
  19. 19. HOW THE MEDI-CAL SPEND DOWN PROCESS WORKS?
  20. 20. In Order to participate in the Medi- Cal Spend Down process, you need to establish that you are currently Spending a large part Of your money On medical care 3;. S(‘II()I~IlZR LAWGROUP _ prObzilc. lrus1s. cslalcs A ' , l_I I ___, -1.(r_7x—
  21. 21. P In other words, you need to show that you are ‘‘medically needy. ”
  22. 22. If you make that Showing and your income exceeds the income limits to generally qualify for Medi-Cal, you will then be allowed to deduct the cost of your outstanding medical expenses from your income, in order to qualify 3;. S('IIOI~IliR LAWGROUP _ probate. trusts. estates A I , l_I I ___, -1.(_r7x—
  23. 23. Once you have been determined eligible for Spend down, you must re—enroll in the Spend Down program every three months 3;. S(‘IIOI~IlZR LAWGROUP _ probate. trusts. estates A I , l_I I ___, -1.(_r7x—
  24. 24. How DOES MEDI-CAL DETERMINE YOUR RESOURCES? . ' St'II(); ~II-LR I. . CrI<()tI’ I probate. trusts. estates rm
  25. 25. Medi-Cal will divide your assets into two categories, when evaluating eligibility; countable assets and exempt assets. Countable assets are assets that are necessary for your care, prior to receiving Medi-Cal 3;. S('IIOIvIliR LAWGROUP _ probate. trusts. estates A I _l, I I aj
  26. 26. Exempt assets are assets that are not considered or counted by Medi- Cal as necessary for providing care Exempt assets may be subject to recovery after your death, however 3;. ScHoMt~: R LAWGROUP _ pr0bz11c.1rus1s, cstalcs A ' , |_ ___, -1.(_r7x—
  27. 27. INCOME LIMITS FOR SINGLE INDIVIDUALS ; ' S('I| (); ~Il-LR L. (}}1<<>L‘1> ' pruhulc. trusts. cslulcs in
  28. 28. A single individual is allowed to have up to $2000 in cash and investments, as well as a primary residence, if they plan to return to it 3;. SCHOMIZR LAWGROUP _ probate. trusts, estates A ' JJ __/ -é‘-ij
  29. 29. If the single individual is living in a nursing home, she is allowed to retain $35 of income per month for personal use, with the rest of the income being applied to the cost of her medical care 3;, SCHOMIZR LAWGROUP _ probate. trusts. estates A ' , |_l l __, —1<r_7x—
  30. 30. INCOME LIMITS FOR MARRIED COUPLES , ' St'l| (); tIl-LR l, . (}}1<<>t1> ' probate. trusts. estates rm
  31. 31. For those who are married, the countable assets are different. The well spouse who lives at home will be able to keep the home, one car, his or her personal properw, and approximately $100,000 (depending on the state’s current limits) in cash and investments 3;, SCIKJMIZR LAWGROUP ' H _ probate. trusts. estates ___, -1.(_r7x—
  32. 32. 1 -‘: /V SCll()Mt: ZR LAWGROUP The well spouse is also given a portion of the couples monthly income probate. trusts. estates _, _‘: _.
  33. 33. LIMITATIONS AND REQUIREMENTS ARE SUBJECT TO CHANGE , ' St'l| (); tIl-LR l, . (}}1<<>t1> ' probate. trusts. estates rm
  34. 34. Medi-Cal’s income limitations and eligibility requirements are subject to change every year. For this reason, it is crucial that you confirm the current requirements with your county Medi-Cal office at least once a year 3;, SCIKJMIZR L/ ’GROUP _ probate. trusts. estates A ‘V , |_l l ___, -:. f7x—
  35. 35. Also, before your initial application, you should consult with your Medi- Cal planning attorney for advice on how to convert your countable assets to exempt assets 3;, SCIKJMIZR LAWGROUP _ probate. trusts. estates A ' , |_l l ___, -1.(_r7x—
  36. 36. Your attorney can also help you take steps to protect your assets from recovery after your death, with appropriate estate planning techniques 3;, SCIKJMIZR LAWGROUP _ probate. trusts. estates A ' , |_l l ___, -1.(_r7x—
  37. 37. COMMON METHODS FOR PRESERVING YOUR ASSETS , ' St'I| (); ~Il-LR l, . (}}1<<>t1> ' probate. trusts. estates rm
  38. 38. There are several useful strategies for protecting as much of your personal assets as legally possible, when you are applying for Medi-Cal 3;, SCHOMIZR LAWGROUP _ probate. trusts. estates A ' , |_l l ___, -1.(_r7x—
  39. 39. Essentially, the goal is to preserve your countable assets by spending them On exempt assets, such as prepaying funeral expenses, paying off a mortgage, 3;, SCHOMIZR LAWGROUP _ probate. trusts. estates A ' , |_l l ___, -1.(r_7x—
  40. 40. Making home repairs and updating home furnishings and appliances, replacing an Old automobile, paying for more care at home, and buying a new home 3;, SCHOMIZR LAWGROUP _ probate. trusts. estates A ' JJ l __/ -é‘-ij
  41. 41. —, ..~; SCHOMER LAW GROUP "' , -‘_, probate, trusts, estates L,
  42. 42. If you have questions regarding Medi-Cal spend down, or any other Medi-Cal planning issues, please contact the Schomer Law Group either online or by calling us at (310) 337-7696 3;, SCHOMIZR LAWGROUP _ probate. trusts. estates A ‘' , |_l l ___, -1.(r_7x—
  43. 43. LEARN MORE ABOUT MEDI-CAL SPEND DOWN IN CALIFORNIA
  44. 44. ’. .* C2,, '- V *4 , :~‘ 1.1 L, , i:i. i”§p A A SCHOMER LAW GROUP probate, trusts, estates

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