MEDI-CAL FOR LONG-TERM CARE

Many families first come to us when they are faced with a Medi-Cal crisis. Their loved one has just been discharged from the hospital and is in a nursing home when they learn that Medicare only pays for up to 100 days of skilled nursing. On top of that, they are told that they have too many resources making them ineligible for Medi-Cal. They are told to reapply after the y have spent down - exhausted - their life savings. Sadly, the $6,000 per month cost of nursing home care will rapidly deplete their savings. They aren't always told about their options.

The first question our clients ask is how can they afford to pay for the quality care that they or their loved one needs and still protect assets for a husband, wife, or other family member without all of their hard earned savings being consumed by extremely expensive long-term care costs?

In other words, how can they get quality care for themselves without going broke or losing the house?

THE MOYNIHAN LAW FIRM helps seniors and their families find the right answer to this vital question. As discussed in the Life Care Planning section of this website, we help our senior clients and their families find, get and pay for quality long-term care. Knowledge of how to qualify for Medi-Cal benefits often plays a central role in answering the question about how to pay for quality long-term care.

Medi-Cal is a public benefits program that many seniors access in order to help pay for the high costs of long-term care in a nursing home. As a matter of fact, in California most seniors rely on Medi-Cal to pay for nursing home care. Still, many misconceptions exist. And these misconceptions can cost people thousands- even hundreds of thousands - of dollars.

Common Misconceptions

Medicare will cover the cost of a nursing home stay. The truth is that Medicare only pays for up to 100 days of skilled nursing care. Once the level of care drops from skilled nursing to custodial care, Medicare stops paying. So does most private insurance. Beyond that, the patient must use other resources to pay. If Medi-Cal pays for long-term care, the quality of care will be diminished. Federal law prohibits facilities from discriminating against residents based on the source of their payment.

Many of our clients believe that they must "spend down" their life savings to almost nothing in order to become eligible for Medi-Cal.

Additionally, they think that an automatic penalty applies to any transfers they might make during a 5 year "look back" period.

They are often shocked and relieved to find out they are wrong. It's not their fault. The rules that apply to getting Medi-Cal to pay for long term care coverage are complicated and can be difficult to understand - particularly since California still operates under rules that have been replaced by much more stringent regulations elsewhere. However, Medi-Cal planning still requires expertise in dealing with the complicated rules regarding countable and exempt assets, asset transfers, and understanding the meaning of such terms as "spend-down and "look back"

The good news is that right now is actually easier to qualify for Medi-Cal called Medicaid in the rest of the country, in California than in other states. But the clock is ticking. We know rules are about to change starting in 2009.

In addition to helping our clients obtain Medi-Cal benefit to pay for long-term care, our planning helps our clients protect their house from Estate Recovery.

It is equally important to know that good planning can also protect your loved ones from losing your house or other assets to Medi-Cal estate recovery.

If you or someone you love needs help because of their age or health situation, the team at the Moynihan Law Firm can help you navigate the long-term care maze, qualify for Medi-Cal benefits to stop the drain on your finances that expensive long-term care causes, and protect everything you are legally entitled to protect.