Medi-Cal Qualification Assistance With The Sate Of California Medi-Cal Program

MEDI-CAL PLANNING AND QUALIFICATION ASSISTANCE

MEDI-CAL ELIGIBILITY PLANNING TO QUALIFY FOR MEDI-CAL BENEFITS

There are three very important areas to consider in developing a comprehensive Medi-Cal plan:

1.         Eligibility Planning - to qualify for Medi-Cal benefits;

2.         Income Planning - to reduce or eliminate a Medi-Cal beneficiary’s monthly “share of cost”
                                                co-payment; and

3.         Medi-Cal Recovery Planning - to reduce or completely eliminate Medi-Cal recovery against the
                                                beneficiary’s estate.

Our office will carefully review your assets, income and estate planning documents to develop a
comprehensive Medi-Cal plan tailored to your specific situation. We typically offer our clients several
alternative strategies and thoroughly review each strategy with our clients so that they can make an
informed decision.

WHAT IS MEDI-CAL?

Medi-Cal is the state of California’s version of the federal Medicaid program that provides additional health
insurance for qualified individuals who are 65 years of age, blind or disabled. Medi-Cal is particularly helpful
for individuals who are residing in a skilled nursing home that have exhausted their Medicare skilled nursing
home coverage. While Medicare may cover the first 20 days of skilled nursing home expenses, coverage
for days 21 through 100 requires a co-payment of $119.00 per day and is only available if the patient
continues to show improvement in his or her condition. On the other hand, Medi-Cal will continue to pay for
skilled nursing home expenses indefinitely, regardless of whether or not the patient continues to show
improvement.

Unfortunately, many people are misinformed about the eligibility criteria Medi-Cal uses to determine
eligibility. Such misinformation is likely due to the ever changing and complicated Medi-Cal regulations.
Despite what you might have heard, you do not have to be destitute in order to qualify for Medi-Cal benefits.
With the guidance of a knowledgeable elder law attorney, it is legal to implement various planning
techniques in order to qualify for Medi-Cal benefits.

Our law firm is experienced in developing and implementing various Medi-Cal planning techniques to quickly
qualify an individual for Medi-Cal benefits and to minimize or completely eliminate any state recovery for
benefits received. Medi-Cal planning is our passion and we take great pride in developing sound planning
options for our clients tailored to their unique circumstances.

STANDARD ELIGIBILITY LIMITS FOR LONG TERM CARE MEDI-CAL BENEFITS

The applicant must be 65 years of age, blind or disabled in order to receive Medi-Cal Long Term Care
benefits. A single applicant may not have more than $2,000.00 (for 2007) in “non-exempt” assets, while a
married applicant is allowed $101,640.00 (for 2007) in “non-exempt” assets.

Medi-Cal classifies certain assets as “exempt” and their values are not used in the determining an
applicant’s eligibility. The following are the major assets considered “exempt” by Medi-Cal in determining
eligibility:

• Principal Residence                                                • Certain Life Insurance
• One Vehicle                                                               • Household Goods
• Most Qualified Retirement Accounts                  • Burial Plots

It is important to understand that the above are “standard” Medi-Cal eligibility limits. For married applicants,
it is possible to significantly increase the “standard” $101,640.00 limit through a “3100 Court Petition” or
“Administrative Fair Hearing.”

Again, a Medi-Cal eligibility plan should only be carried out under the guidance of a knowledgeable California
elder law attorney familiar with Medi-Cal regulations.

“SHARE OF COST”

Although an applicant’s income is not an eligibility factor, Medi-Cal does review an applicant’s income to
determine the applicant’s monthly co-payment (“share of cost”). The formula used to determine an
applicant’s “share of cost” has many variables and often allows the applicant’s spouse to retain a large
portion of the applicant’s income.

MEDI-CAL ESTATE RECOVERY

Medi-Cal keeps track of the total amount of benefits it pays out over the lifetime of a Medi-Cal beneficiary
and attempts to recover that amount from the beneficiary’s remaining estate. Medi-Cal may only recover
from the assets that the Medi-Cal beneficiary has an ownership interest in at the time of their passing, and
only after the Medi-Cal beneficiary’s spouse also passes away. Thus, the Medi-Cal beneficiary’s spouse will
have unrestricted use of the assets for the remainder of their life.

COURT PROCEEDINGS AND ADMINISTRATIVE FAIR HEARINGS TO QUALIFY
FOR MEDI-CAL BENEFITS

For married couples, a “3100 Court Petition” or “Administrative Fair Hearing” are often valuable tools used
to significantly increase the standard $101,640.00 Medi-Cal eligibility limit. Additionally, a “3100 Court
Petition” may be used to reduce or possibly eliminate the “share of cost” co-payment and to transfer all
assets to the Medi-Cal beneficiary’s spouse thereby eliminating potential Medi-Cal recovery.

MEDI-CAL SERVICES PROVIDED BY OUR LAW OFFICE

We understand that Medi-Cal planning can be an emotional undertaking for you and your family. Our office
will make the Medi-Cal process as easy as possible by providing the following services:

•        Preparation and explanation of alternative Medi-Cal planning strategies available for your specific
          situation;
•        Implementation of the Medi-Cal qualification strategy of your choice;
•        Preparation of the Medi-Cal application forms;
•        Our office will deal directly with Medi-Cal on your behalf through completion of the application
          process;
•        Preparation of estate planning documents (if applicable); and
•        Preparation of all documents necessary to reduce or eliminate Medi-Cal recovery (if applicable);

A WORD OF CAUTION

Medi-Cal regulations are constantly updated and changed. Medi-Cal planning should only be done under the
supervision of an elder law attorney familiar with Medi-Cal. Certain transfers of property can have
significant tax ramifications that should be discussed with your attorney. Furthermore, improper transfers
can disqualify a Medi-Cal beneficiary and result in a significant period of ineligibility for Medi-Cal benefits.

Contact our office today to schedule a FREE consultation in our office or at your home. We also have
conference rooms available for meetings at 22 locations throughout Los Angeles County. Please also take
time to review our “Medi-Cal: Frequently Asked Questions” for additional information.